Tai Chi In The Hospice Setting

Tai chi is a slow moving meditative exercise that has health benefits:

• Increased relaxation
• Decreased anxiety
• Decreased pain
• Increased strength
• Improved breathing
• Increased ability to focus
• Increased flexibility
• Improved balance

These benefits will enhance the quality of life not only of hospice patients, but also of their family members, hospice personnel, and bereaved loved ones.

Tai chi for hospice patients:

• It is ideally introduced to patients while they are still ambulatory, but it can be introduced (with modifications) anywhere along the hospice journey.
• Tai chi can be done standing, sitting, or lying down.
• Tai chi helps with anxiety and pain.
• Tai chi helps to maintain function longer.
• Tai chi is something to do that is beneficial.
• Tai chi can be done with the rest of the family.

Tai chi for family members:

• Tai chi relieves some of the stress of care giving.
• It is an activity that can be done with loved one on hospice service; may be done standing along with the loved one who is doing the exercises in bed or in a chair.
• Tai chi is a way to exercise using little space and no special equipment.
• It increases energy.
• Tai chi has been shown to increase activity of the immune system and may help to prevent illness.

Tai chi for hospice personnel:

• Abdominal breathing between patients helps to relieve stress and re-energize you.
• Tai chi at the beginning and/or the end of the work day helps to bring you to a place of focused calm.
• Tai chi in association with team meetings focuses and calms team members, setting the stage for a productive meeting that encourages coherence among team members.

Tai chi in bereavement:

• Begin and/or end bereavement support group meetings with tai chi to enhance energy and decrease anxiety.
• Encourage people in bereavement to practice tai chi at home on a regular basis. This establishes a sense of order in their lives while introducing an exercise that enhances health while decreasing anxiety.
• Encourages positive connections with other people.

Benefit to the hospice:

• It will improve the coping skills of patients and their family members.
• Tai chi will help with pain and anxiety in patients and their family members.
• When patients and family members know tai chi and abdominal breathing, they will sometimes be able to de-escalate an anxiety crisis on their own.
• Urgent phone calls and home visits may well be decreased.
• It will help with anxiety in hospice personnel and may well help with retention and illness issues.

Getting started:

• Devote an hour or two for an introduction to tai chi for the hospice team.
• Obtain two or three copies of Dr. Paul Lam’s tai chi videos for check-out.
• Introduce a new move or concept at the weekly team meetings or do it once or twice a month.
• Use tai chi instructor volunteers to teach patients and staff. Have a certified tai chi instructor as team leader so that there is consistency in the teaching.

Suggested exercises: For more detailed information about these exercises, please go to Dr. Lam’s website, taichiproductions.com.

Abdominal breathing:

Tai chi is always done with abdominal breathing. With the attention focused on the dan-tien (3 fingerbreadths below the belly button), the lower abdomen is inflated during inhalation and deflated during exhalation. This type of breathing ensures that a deep breath is taken and that focus is on the breath, not on concerns running through the mind.

Warm-ups:

In the ambulatory setting, the warm-ups can be used to introduce the tai chi principles of continuous flow, moving against gentle resistance, awareness of weight distribution, and use of abdominal breathing. These warm-ups can be modified for use in a chair or even in a bed.

Tai chi walking:

Ambulatory patients will appreciate the slow tai chi walking where they are walking quite slowly focusing only on an upright posture and gradual weight shifts from foot to foot. Tai chi walking improves balance and leg strength while helping the mind to focus its attention on a part of the body that doesn’t ordinarily get much attention. This focus removes the attention from areas of pain and places focus on the feet and gradual weight shifts. People report a decrease in anxiety and a slowing down of the thoughts in the mind as they tai chi walk. Bed-bound patients can tai chi walk through visualization. Studies have shown that visualization of an activity is almost as good as the activity itself and has the added benefit of being able to visualize a level of expertise that the body may not yet be able to achieve.

Five Element Qigong exercise:

This exercise can be done in the standing, sitting, or lying positions with only minimal modifications. During the exercise attention is focused initially on the earth element, then the air element and then the water element followed by the wood element and finally the fire element. Each element has particular movements and practitioners are encouraged to think of those specific elements in nature as they do the movements. It is a way to connect with nature when actual access to nature is limited.

Basic Tai Chi for Arthritis form:

This tai chi form was developed by Dr. Paul Lam as an introduction to tai chi that can be modified to accommodate a variety of physical limitations. It can be done standing, in a chair or even in a bed.

If you have further questions about tai chi’s use in the hospice setting, please feel free to contact me through my website.

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