Integrating Complementary Care

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Thank You. Pi?on Wellness CommitteeEvy Cugelman, RN, BA, QTTT, CVTSandy Ransom, RN, MSHPMary Dieffenbach, RN, Doctor of NaturopathyJeanne Wolf, CTRSConnie Kohl, RN, NHAMary Lynn Willis, MS, RD, LDMarcia Brenowitz, NHASusan Hanson, BSW. Why do this?. The goal is to achieve well-being in our r

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Integrating Complementary Care

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1. Integrating Complementary Care A Train the Trainer Model

2. Thank You Piñon Wellness Committee Evy Cugelman, RN, BA, QTTT, CVT Sandy Ransom, RN, MSHP Mary Dieffenbach, RN, Doctor of Naturopathy Jeanne Wolf, CTRS Connie Kohl, RN, NHA Mary Lynn Willis, MS, RD, LD Marcia Brenowitz, NHA Susan Hanson, BSW

3. Why do this? The goal is to achieve well-being in our residents and our staff. To have well being means you have to have a sense of Wellness.

4. What is Wellness? Wikipedia says “Wellness is generally used to mean a healthy balance of the mind, body and spirit that results in an overall feeling of well-being.” The term has been defined by the Singapore-based National Wellness Association as “An active process of becoming aware of and making choices toward a more successful existence.”

5. What is Wellness? Wellness can also be described as "the constant, conscious pursuit of living life to its fullest potential,” or “Wellness is all you are capable of becoming.”

6. Wellness Is.... Wellness is an active process where we make choices for ourselves in the interest of wholeness and health which we equate with Holistic Health. The definition of Holistic Health by the American Holistic Nurses Association is “Holistic Health is the state of body, mind, emotion, spirit within the framework of an ever changing environment”.

7. Wellness

8. Balance Within This speaks to a sense of balance within each of us. One can achieve this state of balance, no matter what has been dealt to them.

9. An Inspiration! A young woman with Multiple Sclerosis who lives in a nursing home recently said that she is happy most of the time and when she isn’t, she takes happiness from inside where she stores her wonderful moments, experiences and relationships. WOW!!! - she chooses to accept what life has dealt her and to live in present time taking in all of the opportunities to live a full life rather than live in anger, rage and victimhood.

10. Wellness is... Wellness is about how we choose to live, who we choose to be in relationship with and how to honor and respect all and who we encounter. Wellness is a choice. It means taking control of your own life and being who you want to be. It means honoring yourself completely and accepting yourself as you are.

11. Wellness Is.... It means changing things about you that you don’t like or accept so that you can wake up each day knowing and loving yourself.

12. Why do This? Piñon Management is committed to the well being of all who live and work in Piñon Long Term Care Homes. To achieve the highest level of well being, we believe that by offering complementary care modalities to everyone we can improve quality of life, reduce the quantity of medications that people take and continue to build community in our homes.

13. Why do This? F tag 329 states that two non pharmacologic methods must be tried before using psychotropic medications. What about sleep? Do we over prescribe sleeping medications. Is there another way?

14. Integrative Health Care To achieve maximum Quality of Life and Quality of Care we must focus on an Integrative Health approach to care.

15. Defining Principles of Integrative Medicine From the Arizona Center for Integrative Medicine Patient and practitioner are partners in the healing process. All factors that influence health, wellness, and disease are taken into consideration, including mind, spirit, and community, as well as the body.

16. Defining Principles of Integrative Medicine Appropriate use of both conventional and alternative methods facilitates the body's innate healing response. Effective interventions that are natural and less invasive should be used whenever possible. Integrative medicine neither rejects conventional medicine nor accepts alternative therapies uncritically.

17. Defining Principles of Integrative Medicine Good medicine is based in good science. It is inquiry-driven and open to new paradigms. Alongside the concept of treatment, the broader concepts of health promotion and the prevention of illness are paramount. Practitioners of integrative medicine should exemplify its principles and commit themselves to self-exploration and self-development.

18. Integrative Medicine and Culture Change The principles as defined above equate to principles and values of Culture Change in Long Term Care. Eden Alternative Principle 7: Medical treatment should be the servant of genuine human caring, never its master.

19. Integrative Medicine and Culture Change Pioneer Network Values and Principles Respond to spirit, as well as mind and body. Promote the growth and development of all. All elders are entitled to self-determination wherever they live. Relationship is the fundamental building block of a transformed culture.

20. How and Where to Start The Piñon Integrated Wellness Committee was formed in 2010. It was decided this program should be a “train the trainer” program, so that every home had an educator to train staff and residents. Staff were seen as vitally important in getting this training as many in our homes do not have the opportunity to learn this on their own.

21. How and Where to Start Questions came up on how to finance this especially getting experts to come to the homes and train. It was realized that there were many people in Piñon Management who were educated in holistic modalities. These individuals came together to form the committee and write the curriculum.

22. Which Modalities Would Benefit the Most? Eight modalities were chosen. Each of the eight was relatively easy to learn and each had a qualified educator to write the curriculum.

23. Which Modalities Would Benefit the Most and be Most Cost Effective? Aromatherapy Holistic Dining Spirit of Wellness Program -Drum and Rhythm Circles Relaxation Tai Chi Therapeutic Touch Basic Massage Yoga

24. Aromatherapy Chosen because it is the art and science of utilizing naturally extracted aromatic essences (essential oils) from plants to balance, harmonize, and promote the health of body, mind and spirit.  Essential oils are believed to have antibacterial, deodorizing, and antiviral properties.

25. Aromatherapy Essential oils are used for calming analgesic effect uplifting stimulating effects have also been observed to help sleep anti-bacterial, anti-fungal and anti-viral

26. Aromatherapy Essential oils can be used safely in massage oils and creams and inhaled with the use of diffusers. It is easy to use. It’s inexpensive. Basic aromatherapy is easily taught.

27. Holistic Dining

28. Holistic Dining Staff residents and families can be taught to eat healthfully. Eating for Wellness Contributes to:  Improved Health Disease Prevention Feelings of Well-being Increased enjoyment in eating

29. Holistic Dining The human body is a wonderful mechanism that can optimally function in health only when it is given all the nutrients it needs to attain its highest level of performance. Poor nutrition (mal-nutrition) can result from too little of the needed nutrients or too much intake of harmful substances. As we gradually shift to a healthy eating lifestyle, we will start to feel better.

30. Holistic Dining As we shift away from fast foods, canned, processed and pre-packaged foods our taste buds will adapt and we will be able to taste and enjoy nutrient-dense foods to a greater degree.

31. Holistic Dining What are the problems with the Standard American Diet? This way of eating is high in salt, unhealthy fats, and sugars. The high animal fat level and deep fat fried in fast foods, canned, prepared and processed foods leads to increased fats in the bloodstream which increases the risk for cardiovascular disease. The high sodium (salt) level in fast foods can play a role in increasing blood pressure. High blood pressure is the number one risk factor for stroke.

32. Holistic Dining Americans generally eat 150% more salt than their bodies need. Fast food is addictive. The more deep fat fried foods, sugar, and salt we eat, the more it dampens our taste buds and makes us crave fat, sugar and salt. The good news is that taste buds can be re-educated!

33. Holistic Dining The more we eat fruit, vegetables, and minimally processed foods low in salt and other additives, the better we will be able to savor the delicate flavors and aromas of real food and the healthier we will become. Food cooked lightly such as sautéing, moist-cooking methods such as steaming or crock pots, retain nutrients and reduce free radicals.

34. Holistic Dining It is believed that by teaching healthy dining choices, residents and staff will benefit by having more energy, less illness and will experience physical well being.

35. Spirit of Wellness Program- Drum and Rhythm Circles

36. Spirit of Wellness Program- Drum and Rhythm Circles

37. Spirit of Wellness Program- Drum and Rhythm Circles

38. Spirit of Wellness Program- Drum and Rhythm Circles

39. Spirit of Wellness Program- Drum and Rhythm Circles

40. Spirit of Wellness Program- Drum and Rhythm Circles

41. Leading a Drum and Rhythms Circle There is a role in the music circle for every resident community member and staff member in your home! Some people will be physically capable of reaching out to bang a table drum or a djembe type drum on the floor. Others will be able to tap along using a smaller hoop type drum which they hold in their laps.

42. Leading a Drum and Rhythms Circle Some people will be able to follow the rhythm pattern and others will add a creative flair with their individual spontaneous playing. There are a number of rhythm instruments which can be enjoyed by people who cannot drum related to contractures, spasticity, hemi paralysis or any condition that limits their mobility.

43. Leading a Drum and Rhythms Circle Why Drum Drumming is accessible. The drum is a user-friendly instrument that everyone can play. Drumming is immediate, it offers a unique learning curve with fast results. Drumming is inclusive, it creates a common ground for novices and experts, young and old, disabled and able-bodied.

44. Leading a Drum and Rhythms Circle Drumming allows self-expression, it is a medium of non-verbal creativity. Drumming allows communication across cultures, ages, and disabilities. Drumming releases stress. Its unique aesthetic enjoyment creates a palette for physical and emotional release. Drumming brings people together for an amazing experience.

45. Leading a Drum and Rhythms Circle Drumming and participation in group rhythm sharing is a fun, natural and effective tool in building and supporting a sense of community. From the earliest times in man’s history, people have gathered together among clans and tribes to make sounds and use rhythms to celebrate, build unity and enjoy leisure time.  

46. Leading a Drum and Rhythms Circle There is an ever increasing amount of research which points to the many physical and psychological benefits of drumming and participating in rhythm activity. Some of these include: a sense of belonging a reduction in stress an opportunity to experience self expression and creativity range of motion exercise in a fun mode relaxation

47. Relaxation

48. Relaxation Food for Thought 1) There are a million and one things I must do 2) A thousand and one things I ought to do 3) A hundred and one things I should do BUT only one thing I NEED to do…. Look after me… without whom there is no 1, 2 or 3

49. Relaxation It is important to be self-full and take care of ourselves so that we can take care of others It is important to change your perspective on taking care of yourself

50. Relaxation What do you think when I say put yourself first? Frequent responses It would be selfish I just want people to like me I can do it all I can't say no I'm too busy I’ve just got to get through this first I've got to take care of my kids, husband, parents, friends, etc. first

51. Relaxation If you don't take care of yourself first, you won't be able to take care of people you care about. This is illustrated by the analogy of airlines telling you to put your oxygen mask on first before helping others. It’s simple; if you don't put yours on first and you pass out, neither one of you are going to make it.

52. Relaxation When we experience excessive stress, whether from internal worry or external circumstance, a bodily reaction is triggered, called the "fight or flight" response. The "fight or flight” response is our body's primitive, automatic, inborn response that prepares the body to "fight" or "flee" from perceived attack, harm or threat to our survival.

53. Relaxation The relaxation response is a state of deep rest that is the polar opposite of the stress response. It is defined as your personal ability to make your body release chemicals and brain signals that make your muscles and organs slow down and increases blood flow to the brain.

54. Relaxation The relaxation response brings your system back into balance: deepening your breathing, reducing stress hormones, slowing down your heart rate and blood pressure, and relaxing your muscles.

55. Relaxation In addition to its calming physical effects, research shows that the relaxation response also increases energy and focus, combats illness, relieves aches and pains, heightens problem-solving abilities, and boosts motivation and productivity. Best of all – with a little practice – anyone can reap these benefits.

56. Relaxation Real relaxation is a focused, intentional period of time during which one is mindful and alert, and yet one's muscles are relaxed. It's not as easy as it might sound. When you get good at it, it restores energy and boosts mood and performance levels better than any of these other activities.  

57. Relaxation Relaxation techniques are an essential part of your quest for stress management. Relaxation isn't just about peace of mind or enjoying a hobby. Relaxation is a process that decreases the wear and tear on your mind and body from the challenges and hassles of daily life.

58. Relaxation Benefits of Relaxation Slow Heart Rate Lower Blood Pressure Slow Breathing Rate Increase Blood Flow to Major Muscles Reduce Tension and Chronic Pain Improve Concentration Reduce Anger and Frustration Boost Confidence to Handle problems

59. Relaxation Learning basic relaxation techniques is easy, often free or low cost, and poses little risk.

60. Tai Chi

61. Tai Chi

62. Tai Chi

63. Tai Chi

64. Tai Chi

65. Tai Chi Tai Chi (pronounced tie-chee) integrates mind, body and spirit. Tai Chi originated in China as a martial art and a means for self defense. Tai Chi is sometimes referred to as "moving meditation”. Practitioners move their bodies slowly, gently, and with awareness, while breathing deeply.  

66. Tai Chi Tai Chi is now practiced more for its therapeutic benefits, which include reducing stress, promoting balance and flexibility, and even easing arthritis pain.  

67. Tai Chi Tai Chi literally means "Supreme Ultimate" and encompasses the belief that everything in the universe depends on the interaction between the polar opposites of Yin and Yang. Yin is represented by night, negative, soft, earth, and intellectual. Yang is represented by day, positive, hard, sky, and physical.

68. Tai Chi

69. Tai Chi At the core of Tai Chi is the concept of Taoist Yin and Yang. Think of Yin and Yang as almost being opposites. i.e. Yin translates as "cloudy," while Yang translates as "sunny."  Yin and Yang are constantly moving and changing.

70. Tai Chi Tai Chi is a method of trying to keep the Yin and Yang of your body balanced and in harmony, for it is believed that we are strongest and healthiest when we're balanced.

71. Tai Chi When using Tai Chi for health the focus is on movement and breathing. This combination creates a state of relaxation and calm, relieving the physical effects of stress on the body and mind. In Chinese philosophy and medicine there exists the concept of 'Chi', a vital force that energizes the body.

72. Tai Chi One of the avowed aims of Tai Chi is to foster the circulation of this 'Chi' within the body, the belief being that by doing so the health and vitality of the person are enhanced.

73. Tai Chi Learning to do Tai Chi forms correctly provides a practical avenue for learning about such things as balance, alignment, fine-scale motor control, rhythm of movement, and so on. Stress, anxiety and tension should melt away as you focus on the present, and the effects may last after you stop your Tai Chi session.

74. Tai Chi Health Benefits Reduced anxiety and depression Improved balance, flexibility and muscle strength Reduced falls in older adults Improved sleep quality Lowered blood pressure Increased energy Improved overall feeling of well-being

75. Tai Chi Research on Health Benefits of Tai Chi Oregon Research Institute Found increased balance and strength among participants in the study. Improved sleep quality and length. National Institute on Aging Found that Tai Chi exercises cut the fear of falling and risk of falls among older people.

76. Tai Chi University of Illinois Study of seniors with average age of 80 noted strong improvement in balance, energy levels, ability to balance, flexibility and sleep quality in as little as 6 months. Study on Osteoarthritis: People with osteoarthritis assigned to a Tai Chi group during a three-month study reported less joint pain and stiffness than when they started. They also had less pain and stiffness than those in a control group. 

77. Tai Chi Who Can Do Tai Chi? Everyone and Anyone. Most forms are gentle and suitable for everyone. Tai Chi emphasizes technique over strength. Low impact. More than 100 possible movements and positions to choose from. It can be done from a sitting position.

78. Introduction to Therapeutic Touch (TT)

79. Introduction to Therapeutic Touch TT was developed in 1972 by Dolores Krieger, RN, PhD and her mentor Dora Kunz. It was taught as a Masters level course called The Frontiers of Nursing at New York University. Dr. Krieger’s students were known as the Krieger’s crazies.

80. Introduction to Therapeutic Touch TT is a method of healing that anyone who is interested can learn. It is research based. Anything that is taught by a Krieger/Kunz TT educator has been researched and proven effective.

81. Introduction to Therapeutic Touch Definition of TT TT is a temporary interpretation of several ancient healing practices. It is a consciously directed process of energy exchange during which the practitioner uses their hands as a focus to facilitate healing.

82. Introduction to Therapeutic Touch What this means is that healing has been around as long as mankind. It’s depicted in cave drawings from the last 15,000 years and in the written works for the past 5,000 years. By consciously directed we mean that it is based on learned skills, that anyone can learn and since it was developed for nurses, it means that there is a plan of care when giving a TT session.

83. Introduction to Therapeutic Touch Dora always said “Healing is a natural human potential”. What drives the healing session is the compassionate interest of helping someone in need and the intentionality to make this come about. TT can work with all traditional as well as contemporary healing & helping modalities.

84. Introduction to Therapeutic Touch TT does not have a religious context and its effects do not rely on the healee’s faith or on placebo effects.

85. Introduction to Therapeutic Touch Clinical Thermography was used to visualize the effects of TT. Clinical thermography is a noninvasive diagnostic technique that allows the examiner to visualize and quantify changes in skin surface temperature as affected by vascular and sympathetic nervous system changes.

86. Introduction to Therapeutic Touch

87. Introduction to Therapeutic Touch

88. Introduction to Therapeutic Touch

89. Introduction to Therapeutic Touch Therapeutic Touch in Combination With Healing Images Technique (emotional release) for Acute Pain in Neck and Shoulders.

90. Introduction to Therapeutic Touch

91. Introduction to Therapeutic Touch

92. Introduction to Therapeutic Touch

93. Introduction to Therapeutic Touch

94. Introduction to Therapeutic Touch

95. Introduction to Therapeutic Touch

96. Research In the late 60's and early 70's, initial research was conducted by Dr. Bernard Grad Ph.D., Sr. Justa Smith Ph.D., and Dr. Dolores Krieger Ph.D. They studied the phenomenon of the laying on of hands by a healer, Oskar Estabany. They saw that it could increase wound healing in mice, increase the rate of growth in plants, and increase the activity of the digestive enzyme trypsin. As a result, Therapeutic Touch was developed by Dr. Dolores Krieger and Dora Kunz.

97. Research In 1975, Krieger examined the effects of TT as performed by nurses on hemoglobin levels in hospitalized patients. The control group (n=32) received routine nursing care, while the experimental group received TT. The experimental group (n=32) showed a significant increase in hemoglobin levels between pre-and post-treatment, as measured by a Coulter counter in a laboratory setting.

98. Research 1. Promote Physiological Relaxation   (Krieger, D., S. Ancoli, and E. Peper, Searching for Evidence of Physiological Change).  Results: There was no significant change for the patients electromyographic tracings, their galvanic skin response, heart rates or temperatures: However, the patients did have electroencephalographic tracings that demonstrated high amplitude alpha waves in abundance -a sign of relaxation state.

99. Research 2. Reduction in Anxiety (Heidt, The Effect of Therapeutic Touch on Anxiety Levels of Hospitalized Patients). Results: The group receiving the TT treatment had a more dramatic and significant decrease in anxiety levels after the treatment than the other two groups. In this study, the use of TT demonstrates that it is effective in producing a physiological relaxation, and a decrease in anxiety.

100. Research 3. Reduction in Pain Connell-Meehan, Therapeutic Touch and Post-operative Pain: A Rogerian Research Study).  In 1993, Therese Connell Meehan, Ph.D., R.N., re-examined the effect of TT on acute post-operative abdominal or pelvic pain (1993). Results: Showed that TT has the potential to reduce pain in both headache and post­operative abdominal and pelvic pain. However, analgesic medication was required and TT by itself was not sufficient to remove the complete symptoms of pain .

101. Introduction to Therapeutic Touch TT is a method of “healing” which utilizes the energy field surrounding the body to reach and touch the individual at all levels of experience Body, Mind, Emotion, Spirit Healing refers to the integrating tendency within the individual as a whole. The TT practitioner is really a facilitator of the healing process. The person heals themselves.

102. Introduction to Therapeutic Touch The TT practitioner does not cure. Curing implies absence of disease or pathology. Curing implies taking on responsibility for someone’s health. Healing is about caring for someone and facilitating wholeness.

103. Introduction to Therapeutic Touch What Can TT Do? Relaxation Rapid relaxation response, often occurring in as little as two to four minutes Pain Reduction Clinically there is a significant amelioration or eradication of pain

104. Introduction to Therapeutic Touch Accelerated Healing Process Primarily because the relaxation response and relief from pain have positive effects on the healee’s immunological system. TT accelerates the healing process i.e. In the healing of bone fractures, with TT, good callus formation (the precursor to bone development) can be seen in x-rays in about 2 ½ weeks rather than the six weeks it usually takes.

105. Introduction to Therapeutic Touch Alleviation of Psychosomatic Illness Of the physiological systems that are most sensitive to TT, the most sensitive is the autonomic nervous system. This controls your heart rate, breathing and blood pressure, digestion, respiration, salivation and perspiration. TT deals best with many of this system’s dysfunctions, which are at the heart of what are known as psychosomatic illnesses. It is the sensitivity of the ANS to TT that creates the consistent & rapid relaxation response.

106. Introduction to Therapeutic Touch 5. Peaceful Transition TT will help someone who is dying feel a sense of peace and relaxation to help them in their dying process. Many terminally ill patients, once freed from the stress of persistent pain, are able to go on to a peaceful transition. Support the Immune System

107. Introduction to Therapeutic Touch This is a brief introduction to Therapeutic Touch. Anyone can learn and classes are available at Piñon Management. Beginner classes are held 2-3 times per year. If you are interested you can get in touch with Evy Cugelman or 303-883-9264

108. Yoga

109. Yoga

110. Yoga

111. YOGA It is considered a holistic experience which rejuvenates the mind, body, and spirit. The practice is calming and provides a rare opportunity in our chaotic lives to leave the outside world behind and be at peace with ourselves.  

112. YOGA As we age, we stop breathing fully. Yoga reminds us that it is important to exhale as fully as we inhale. As we grow older, we lose flexibility in our ribcage, and sometimes suffer from spinal deformities, creating less room for lung expansion.

113. YOGA Mindful breathing takes into consideration three aspects of breathing: replenishing, warming, and cleansing. Focusing on full inhalations and exhalations serves to slow down the heart rate which, in turn, improves focus and increases concentration.

114. YOGA There are several poses/asanas to use during a yoga practice. We will focus on eleven poses.

115. YOGA  The Child Pose (Bala-asana) The Mountain Pose (Tada-asana) The Half Spinal Twist Pose (Ardha-matsyendra-asana) The Lotus Pose (Padma-asana) Forward Bend (Uttan-asana Cat Pose Cow Pose

116. YOGA Side Bend Eagle Pose (Garud-asana) 10. Warrior I and II (Virabhadr-asana) 11. The Corpse Pose (Shava-asana)

117. Health Benefits of Yoga Sleep – Older adults are often plagued with difficulty falling asleep and staying asleep. The result is a fragmented, poor night’s sleep which reduces daytime alertness. In many cases it is advisable to avoid the use of pharmaceutical sleep aids in older people due to the risk of side effects.

118. Health Benefits of Yoga Strength/Arthritis A study was conducted that measured improvement in hand grip in people with rheumatoid arthritis versus non-arthritic volunteers following Yoga training. Hand and grip strength in both hands increased in non-arthritic adults and in people with rheumatoid arthritis.

119. Health Benefits of Yoga Diabetes A study at the University College of Medical Sciences in New Delhi evaluated people age 30-60 years old with Type II Diabetes (Jain, Uppal, Bhatnagar, Talukdar, 1993). A 4 minute per-day regimen of Yoga was followed for a period of 40 days. The results showed a significant decrease in fasting blood sugar levels. These people showed an average improvement in lung capacity of approximately 10 percent.

120. Health Benefits of Yoga Hypertension Researchers at Bhabha Atomic Research Center, Medical Division, in Mumbai, India, evaluated the overall benefits of Yoga on risk factors for heart disease. After three months of 1-hour daily Yoga practiced by their research group of 20 patients, 35-55 years of age, all who had mild to moderate high blood pressure experienced a decrease in blood pressure, as well as a decrease in blood sugar, cholesterol and triglycerides.

121. Health Benefits of Yoga Mood/Anxiety The Harbor-UCLA Medical Center conducted a study to assess what effect, if any, yoga had on stress levels (Gaur, 2001). During the study, all participants expressed that their moods and anxiety levels were improved as a result of their Yoga sessions.

122. Health Benefits of Yoga Chronic Pain Yoga practice has been shown to aid those suffering with chronic pain. A study by the Harbor UCLA Medical Center (Gaur, 2001) found that people experiencing pain either improved or maintained their symptoms after only four weeks of practicing Yoga.

123. Health Benefits of Yoga Lung Problems/Breathing Difficulties Eighty-six people with bronchial asthma who had breathing difficulties were treated using a Yoga-chair breathing procedure composed of simple neck muscle relaxation movements and postures with breath exercises. Seventy percent of the episodes were relieved within approximately 30 minutes. These people gained confidence in this breathing technique and used it before resorting to prescription medication.

124. Basic Massage

125. Basic Massage The term massage comes from the Arabic mass meaning to touch or to feel.  The origins of massage are timeless. Rubbing when things hurt is something we do instinctively, is soothing and gives a general sense of well-being. Massage is basically touch, and touch is something we do every day. Massage is perhaps the oldest and simplest of all treatments.

126. Back Massage

127. Back Massage Through back massage, you reach nerves on the back that spread to every part of the body. Most people feel a deep sense of release after a thorough back massage. Massage can be a great tonic, both physically and emotionally. It can bring a positive and healing touch and a profound state of calm and well-being.

128. Hand Massage

129. Hand Massage A hand massage can be especially relaxing, both because our hands are used to being touched and because the hands have reflex connections with the whole body.

130. Foot Massage

131. Foot Massage The feet carry the entire weight of the body and serve as marvelous shock absorbers. In addition, the sole of the foot contains thousands of nerve endings with reflex connections to the whole body. By massaging the feet, you are affecting the entire body, not just the feet themselves. This can be relaxing to any individual.

132. For More Information Contact Evy Cugelman Pinon Management 303-883-9264

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