Palliative Aquatics ProgramWhat is Palliative Aquatics? Palliative Aquatics is a term I use to describe an aquatic modality especially designed to meet the needs of adults and children who have life span limiting conditions, are medically fragile or nearing the end of their life. The concept of palliative care is relatively new in the United States, especially as the term applies to children. Highlights of the definition given by the World Health Organization include:
The World Health Organization further defines palliative care for children, an aspect of which is summarized below:
In their definition The National Hospice and Palliative Care Organization (NHPCO) adds, “No specific therapy is excluded from consideration.” This discussion of palliative aquatics centers on my experience with children at the George Mark Children’s House who are medically fragile or at end of life. As a nurse and aquatic specialist at George Mark Children’s House (www.george.mark.org) I work to assure that the goals of palliative aquatics embody those of palliative care. My intent during sessions with children and/or their families includes: “providing comfort and support, pain and symptom management, and quality of life.” All aspects of the hydrotherapy program revolve around these goals. Over the course of a thousand aquatic sessions I experienced how perfectly the concepts and principles of Jahara® embody the goals of palliative aquatics. I maintain the alignment of my patient’s body as well as my own while working with the properties of warm water to move a child safely and effortlessly. In so doing, I observe the child’s stiffness and spasticity decreases, improvement in respiratory function, and s/he affect becomes more relaxed and happy. I attempt to “follow the patient’s lead” during a session. Some sessions are interactive and playful. At other times, the patient falls asleep in my arms, lulled by gentle movement or the sound of drums. By far, the most profound experiences we have in the palliative aquatics program are with our children who are dying. Providing sessions during these most sacred moments of their lives require the utmost attention, safety, skill and collaboration. Often the family participates, either as observers on deck or as participants in the water. Sometimes extended families are present, and the atmosphere is joyful and, perhaps, relieved, as they see their tiny relative moved gently in the water. Other times, parents hold their child tenderly in profound silence as they cherish every precious moment. Thus, the palliative aquatics practitioner becomes the sacred, silent witness, the support and the facilitator during some of these most poignant and important events of a family’s personal history. We accept this honor with utter humility, using our knowledge and skills almost invisibly, allowing these special beings to touch us, to teach us, and to change our lives forever.
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Sheila Pyatt