As hospice patients approach the end of life there are several valuable life tasks to perform. The use of integrative therapies allows patients and families to perform these tasks and connect the past, present, and future to self, each other and their community. Therapies such as aromatherapy, relaxation skills, massage, Reiki, music, animal assisted activities, or art, provide comfort to patients and families as well as helping them to incorporate important cultural traditions during the end of life. Aromatherapy, massage, Reiki and relaxation skills help to relieve pain, alleviate anxiety, and treat side effects from medication. Through techniques such as music, art, animal assisted activities and guided imagery, patients are able to find meaning in life, share feelings with others and connect to life events. This workshop will give participants a clear understanding of how integrative therapies may be used at the end of life and the rationale for using specific methods. Case studies of an actual hospice patient, and her use of integrative therapies, will demonstrate the profound effect these techniques can have on patients and families, while on hospice. Case study include a 2 ½ year old pediatric patient with Niemann-Pick Disease, Type A. Finally, a template will be provided to help participants develop and implement their own Integrative Therapies Program.

2. Using Integrative Therapies At The End of Life: Connecting Through the Lifespan Case Studies from Pathways Hospice, San Francisco Bay Area, California, USA Presented by Esther L. Johnson, RN, BC, BSN, PHN Australian College of Holistic Nurses Inc Sixth Biennial Conference Brisbane, Australia October 2004

5. Initial Offerings Relaxation Skills Massage & Caring Touch Aromatherapy Animal Assisted Activities Reiki

6. Expanded Offerings Creative Expression Acupressure & Acupuncture Music & Sound Story Telling & Journaling

11. Pediatric Palliative Care

16. Example of Integrative Medicine: Sophia’s Healing Circle Allopathic Medicine Traditional Medicine Nutrition Naturopathy Medical Research Physical/ Energy Therapies Spiritual/ Psychological Family & Community Support

21. Sophia’s Current Condition

22. Sophia’s World

23. www.sophiasgarden.org

24. To create an environment of healing,wholeness and wellness for all, through the practice of holistic nursing