Complementary Nursing in End of Life Care – interview with Madeleine Kerkhof-Knapp Hayes

Categories: Care.

You wrote ‘Complementary Nursing in End of Life Care: Integrative care in palliative care’ in Dutch, but now it has been translated into English. For whom did you write this book?

This book is written for professionals in palliative and terminal care. Especially nurses and physicians will find a wealth of well-founded information on aromacare and the way some 30 essential oils, and a small but well-chosen range of base oils and other base substances, can be used in end of life care. It offers recipes, guidelines and protocols for every day care.

Think of care for patients in hospice and homecare, but also in nursing homes and hospitals. In The Netherlands usually nurses are trained to offer complementary care in addition to the standard care, and it is still quite rare to see therapists from outside at the patient’s bedside.

In countries like the UK, apart from nurses trained in complementary therapies, we see that aromatherapists and massage therapists, usually from outside, carry out complementary therapies.

For them too, this book will be a guide to complementary care. Also, every chapter offers the reader knowledge about palliative care in general, which can be of great value to all professionals involved in the care of patients in the last stages of life.

The book contains a wealth of specific information. How did you get all the knowledge in the book?

Some thirty years ago I first started training to be a nurse. The main reason to leave the hospital was that I wanted to care for patients in a more holistic way, especially for the most vulnerable patients and the terminally ill.

After I left nursing I gained a wealth of experience and expertise in ‘naturally-orientated’ health care. I also trained and worked as a herbalist and aromatherapist. I graduated as a hydrotherapist in Germany in 2009.

In my practise integrating both standard and complementary care for chronically and seriously ill patients, focussing on the whole patient was my main priority.

In 2003 I started training nurses and other health professionals on complementary care techniques, which I still do today, combining nursing guidelines and skills with complementary interventions. Being a member of several professional bodies, such as the Dutch Society for Complementary Nursing and the American Holistic Nurses Association, studying and networking keeps my expertise and skills up to date.

The many years of experience and training, combined with the Dutch guidelines of the Integraal Kankercentrum Nederland (Comprehensive Cancer Centre of the Netherlands) for palliative care, and always seeking as much scientific foundation as possible for complementary nursing led to my wish to complie this in a book on complementary care in palliative care. This way every professional could use the book to further improve quality of life and dying with complementary care.

In what kind of situations can complementary care have positive results for patients? Which symptoms can be alleviated?

Complementary care can greatly enhance quality of life and dying for patients at the end of life. Of course this applies to a great variety of symptoms, from pain to dyspnoea and from nausea and mouth care to wound care, for which blends, recipes and safe application methods are incorporated in the book.

We have seen great results with innovative interventions in aquacare, originating from hydrotherapy, such as the cool abdominal washing for constipation. This non-pharmacological intervention works genuine wonders, in fact so much, that as we speak a pilot study is ongoing in the academic hospice Demeter in The Netherlands. The preliminary results are promising.

Scent and gentle touch especially can play a large role in emotional wellbeing for both the patient and their loved ones. Using pure and natural essential oils in a variety of ways, such as diffusion, inhalation, baths or gentle massage, can have a positive influence on anxiety, depression, feelings of helplessness, nervousness, and restlessness. Some of the blends in this book have even contributed to finding peace in the dying stage for many patients.

How ‘popular’ (or otherwise) is complementary care in Holland?

A recent study on complementary care in Dutch health care centres in January of this year showed that aromacare is offered in 13.5% of hospitals and 60.8% of nursing homes.

Massage is performed in 25.8% of hospitals and 54.9% of nursing homes. Use in hospice care has not been evaluated separately, but my estimate is that 85% of hospices offer complementary interventions including aromacare. In 80% of the hospices – the study confirms – complementary care is imbedded to such an extent in general hospice care that it is coordinated by a specially appointed person.

Another thing that indicates the popularity – I have trained thousands of nurses and other care professionals over the years: on the job, in my training institute and at conferences and clinical lessons. As a down-to-earth former nurse I pay much attention to efficacy, safety, and practicalities. Rather than training nurses in classical aromatherapy using a wide range of essential oils, I prefer to teach them to add a limited number of well-known and well-founded oils to their general care. This way I strive to help integrate complementary interventions in mainstream care.

‘Complementary Nursing in End of Life Care: Integrative care in palliative care’ is written by Madeleine Kerkhof – Knapp Hayes. For more information, or to order the book, visit her website.

Rob Bruntink is editor-in-chief of Pallium magazine, as well as Pal voor U, a magazine about palliative care specifically for patients and their relatives. Along with his wife, he directs Bureau MORBidee, an organisation aimed at starting the conversation about death in Holland.