CAM (COMPLEMENTARY AND ALTERNATIVE

MEDICINES)
IN PALLIATIVE CARE

OLEH :RETNO DYAH W

Introduction
• Complementary and alternative medicines (CAM)
comprise a diverse array of treatment modalities that
are not presently considered part of
conventional/mainstream medicine. CAM emphasize
a holistic approach towards healthcare, i.e. they are
based on the belief that mind, body an spirit are
interconnected and that health depends on
wholeness and balance between them.
Definitions
• Alternative treatments aim to replace conventional
treatments.
• Complementary treatments are used alongside the
conventional treatments
Types of therapy
• In palliative and supportive care, CAM is primarily used to
increase the client’s well-being, e.g. by alleviating pain and
other symptoms of the disease, improving sleep, reducing
stress and anxiety, or by reducing the adverse effects of
conventional treatments. They are often used as an addition
to conventional treatments. Some CAM modalities claim a
direct effect in the prevention or treatment of cancer. Widely
practised treatments are acupuncture aromatherapy,
herbalism, homeopathy, hypnotherapy, reflexology, relaxation
and spiritual healing.
• The individual therapies described in this chapter will be
considered under four headings: alternative medical
concepts; mind–body interventions, biologically based
therapies and manipulative therapies
Principles of CAM
• A central tenet of CAM is the strong belief in the
uniqueness and wholeness of the individual and the
power of the body to heal itself.
• Often, patients who consult complementary practitioners
have chronic conditions that are diffi cult to manage,
such as HIV infection, multiple sclerosis, rheumatological
conditions and cancer.
• The interest in CAM in the palliative care setting is
perhaps not surprising given the inherent need for the
terminally ill to feel supported with regard to physical,
psychosocial and emotional domains, in achieving an
acceptable quality of life.
Reasons for seeking CAM
• Possible factors contributing to CAM use
• Push factors
• Dissatisfaction with orthodox medicine:
– ineffective
– adverse effects
– poor communication with doctor
– waiting lists
• Rejection of orthodox medicine: anti-science or anti-
establishment attitude
• Desperation
Pull factors
• Philosophical congruence:
– emphasis on holism
– active role of patient
– explanation intuitively acceptable
– natural treatments
• Personal control over treatment
– Good relationship with therapist:
– on equal terms
– time for discussion
– allows for emotional factors
• Accessibility
Group 1: Alternative medical systems
• Acupuncture
• Homeopathy
Group 2: Mind–body therapies
• Relaxation therapy
• Hypnotherapy
• Guided imagery and visualization
• Meditation
• Spiritual healing
• Creative therapies :Art and Music therapies
Group 3: Biologically-based practices
• Herbal medicine
• Aromatherapy
Group 4: Manipulative and body-based
therapies
• Massage
• Refl exology