Giving aromatherapy treatment to the Elderly

[????(:]

Does anyone have any experience/views on this? I feel I'm going round in circles a bit.

I have just started to work exclusively as a volunteer Aromatherapist with a local charitable organisation supporting the elderly in the community. I have just started making home visits.

I am finding that the elderly are usually receiving medication from their GP. In Aromatherapy terms, this is a "medical contraindication". I was ITEC trained and we were trained that GP consent is required for a medical contraindication (see Louise Tucker - Introduction to Aromatherapy page 99).

For the few clients I have seen so far, I have written to their GP’s asking them if there is any medical reason why I can't treat their Patients. This approach has a number of drawbacks. Not only is it is going to be time-consuming from me as a Volunteer Aromatherapist, but I note from reading some of the past posts on the Healthy Pages forums that doctors are often reluctant to sign consent forms from Therapists as they may not be insured to do so. Also, another problem is that the Therapist is writing to the GP and is referring to confidential information about the patient's medical problems which is an area of confidentiality between GP and client.

I phoned ITEC to ask if they had any "policy" in this area. They told me that the Patient should be responsible for obtaining GP consent for Aromatherapy treatments so that the Therapist is not then responsible for writing to the GP referencing the client's confidential medical conditions. I checked on the ITEC site and see that they have a sample disclaimer. The ITEC sample disclaimer comes in two options. One option is that the client signs that they have GP permission and the other one is for the client to sign that they accept responsibility for their treatment.

Whilst this approach seems to be the best way to do things, I am concerned that elderly clients may not want to bother to go to the GP to discuss alternative treatments. If this is the case, the Patient may never progress to the point where they actually put themselves forward for treatment!

And if they don't go to their GP and they elect to sign a personal disclaimer and then they have a negative reaction to the treatment, the Therapist could be asked why they didn't insist that the Patient go to their GP for consent in the first place!

At the very least, if I take the approach to ask the Patient to obtain the OK from their GP, I am thinking that I would need to give the Patient a leaflet with some background information on the clinical effects of massage (lymph drainage, increase in circulation) as well as the effects of essential oils etc to take with them to their GP as some GPs may not have a good understanding of Aromatherapy.


Peter

 

[Black Delilah]

Oh, I forgot to say that I also checked with my insurance provider (Balens) to ask if they had any requirements with regard to consent paperwork.
They said they did not. They said that as long as the Therapist takes detailed case notes, then they are happy from an insurance point of view.

Peter

 

[Celeste *Cherry Flava*]

Hi Aspire2heal

This seems to be a sticky subject whatever therapy you practice. I do aromatherapy, reflexology, massage and IHM, all of which require GP's permission if necessary. I recently wrote to a GP asking if he had any objections to my giving aromatherapy to his patient who was on beta blockers. He did not reply to me but wrote to his patient and told her that I was asking confidential information about her. Luckily this lady was a friend of mine and had seen the wording of my letter before it was sent. This really worried me about future correspondence with GPs. I now think that getting the patient to take responsibility for gaining permission is the best course.

 

[j.mg23]

Hi Peter

I am also ITEC trained. The emphasis does tend to be on the patient contacting their GP - or signing a disclaimer. Unfortunately, sometimes patients are forgetful or not fully aware of all their health problems and writing to the GP can be very helpful. The GP sometimes [more often nowadays] will charge for replying to your letter. They are under tremendous pressure in timings with patients and some simply will not reply leaving you in limbo wondering when you will, and if you will get a response. Some doctors simply dont want to reply because they feel it is your job and part of your profession to take that responsibility.

Often with elderly massage, the client will have a specific treatment rather than full body massage [although that isnt rare], and in writing to a GP I tend to write what I intend to do, the treatments I am going to give, and what the purpose of these treatments will be... [eg massage for pain relief in her knees, or hands etc... or gentle facial and hand massage purely for the purpose of stress relief and relaxation, reflexology on the hands... or feet... etc], or example if an elderly patient had given [as they should details of their medication and health problems] I'd say clearly why I was treating them, and mention that I was aware of them taking beta blockers, or drugs for controlling cholesterol and high blood pressure and then ask the doctor if there were any objections to my treating their patient. I don't normally ask specifically for medical information from the Doctor... what I would be asking is if they considered it safe and advantageous to give treatments to their patient - or not. In most cases I would write to ask if they had any objections to me treating their patient rather than asking any more than that from them.

I believe I have posted some sample letters [a long time ago and they will be out of date now - I've improved thankfully!]... and other people have... in the past. If you did a search for sample doctors letters in the Student section, you should find them.

If you want to write privately, I will be pleased to help.
Best wishes
Little Red

 

[rweavuaninjiyjerr]

I have a couple of close freinds who happen to be GP's & I know that they are loath to get into correspondance with comp. therapists about patients. If I am dubious about a new client, I write to their doc and say that I have spoken to Mrs/Mr soand so, who has asked me to give such and such a treatment. I have only had one reply in many years - the doctor said that he saw no objection for his patient to receive my treatment, unless he was expected to pay!!!!

 

[clueless??]

Many thanks for all the extremely helpful replies. I think I would summarise as follows:-

Therapist obtains GP consent

Pros

The client (particularly an elderly person) may feel reluctant to make a special trip to the doctor to obtain permission
The therapist can explain the effects of Aromatherapy in a covering letter
The therapist can explain to the GP the potential contraindications of essential oils to the conditions that the patient has presented

Cons

Doctors are often unwilling to give consent

As they feel that they are not insured to do so
Doctors are often unwilling to give consent as they believe the Therapist should take the responsibility
As they are not prepared to divulge confidential information

Even if the Doctor does give consent, they may not reply to order and this may hold a treatment.
Doctors may charge nowadays for this service
Time consuming for me as a Volunteer

I think given all this, I'm going to try to ask the clients to obtain prior permission based on some general information I provide them with to take to their GP. My only concern is that this may deter them in coming forward for free treatments. But I'm going to try it and see what happens.

Thanks again everyone.

Peter