Breathing deeply utilizes the natural breathing muscle from the diaphragm and releases natural endorphins.
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1 Deep Breathing What is it? Breathing deeply utilizes the natural breathing muscle from the diaphragm and releases natural endorphins. Rationale Deep breathing from the abdomen promotes the relaxation response. Have the patient sit comfortably Loosen tight clothes from around abdomen Have the patient breathe in slowly (through nose) allowing the abdomen to expand with inhalation Exhale at a normal rate and abdomen should fall toward the back May use pursed-lip to breathe out May use word, sound or counting to help with focus May place hand on chest and abdomen to help with awareness of abdomen rising higher than the chest.
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3 Guided Imagery & Visualization What is it? Imagery is a mind-body intervention that uses the power of imagination to bring about change in physical, emotional, or spiritual dimensions. Guided day dreaming. Rationale Images evoke physical and emotional responses and help us understand the meaning of events. Start with slow abdominal breathing for relaxation Ask patient to describe a place they enjoy Ask to describe what it looks, feels and smells like Summarize process and reinforce practice with practice it is easier to return to this place Several guided imagery CD s are available through the Patient Education Center (MC Relaxation Techniques for Mind, Body and Spirit) and the Wellness channel in Video on Demand
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5 Progressive Muscle Relaxation What is it? Progressive muscle relaxation is the tensing and releasing of successive muscle groups. Rationale A person s attention is drawn to discriminating between the feelings experienced when a muscle group is relaxed and when it is tensed. CD is available for this through the Patient Education Center. (MC Relaxation Techniques for Mind, Body and Spirit) Instruct to tense a muscle group when they hear tense and to release the tension when they hear relax. Tension is held for 7 seconds: - Forehead; face; lower face and jaw - Neck - Hands; forearms - Upper arms - Chest, shoulders, and upper back - Abdomen - Thighs; calves; feet
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7 Meditation What is it? An activity that keeps the attention pleasantly anchored in the present moment. May involve mental repetition on a word or phrase, a physical repetition or body movement or focus on breath awareness. Rationale Meditation is a mind body approach that has shown to decrease mind chatter and promote focus and relaxation. Have patient sit or lie in a comfortable position with a straight spine and let the shoulders drop Close eyes or gaze ahead without focus Focus on full in breath and out breath - notice sensation of the breath Don t try to change the breath, just notice the waves. When the mind wanders away from the breath, just return focus to the breath. May add in a word (mantra) or sounds to help with focus i.e. om, calm, peace.
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9 Music Therapy and Music Listening What is it? Music to induce relaxation has a regular rhythm (less than 80 beats per minute, no extreme pitch or dynamic and a melodic sound that is smooth and flowing). Rationale Used throughout history as a treatment modality. Individual responses influenced by personal preference, the environment, education and cultural factors. Determine a patient s music preferences and assess for adequate hearing Offer to get a CD player and CD s from the Patient s Library Use of the relaxation or wellness channel Encourage patients to use their own music if available Consider a music library for your unit
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11 Simple Massage What is it? The application of manual techniques to produce friction and pressure on cutaneous and subcutaneous tissues. Rationale Produces therapeutic effects on multiple body systems. Massage can increase or enhance movement in the musculoskeletal system. Massage has been found to produce a relaxation response. Offer to provide a back rub, shoulder massage, hand massage or foot massage. Massage strokes: - Effleurage-slow, rhythmic stroking - Pétrissage-kneading, involving lifting a large fold of skin and the underlying muscle - Start with general effleurage stokes, then pétrissage and then end with effleurage again. - Assess patient preference or sensitivity to lotion or bath oil. - Caring Hands Volunteer program is another resource for hand massage available at MCH-RMC & MCH-SMC.
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13 Pain Management Imagery Creating the scale Settle in and relax Take slow deep abdominal breathes Picture and intensity scale (0-10) and focus it clearly in your mind. You can use another image of a scale that can be adjusted if it comes to you. i.e. thermostat Focus on the number that relates to the pain/discomfort and see if on the scale Adjusting the numerical rating on the scale Slowly begin to decrease the number Notice how the pain decreases as the number lowers Slowly continue to lower the number Locking in the new level Notice the pain continues to decrease to the point it is tolerable. You will know what number is right. Notice you feel minimal discomfort or none at all When you reach the final number lock it in place
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15 Daily Self Care Technique Find a comfortable position and breathe Sit quietly in a comfortable position Choose a word that helps you feel relaxed (for example - peace, calm, ocean) Close your eyes Release tension with your breath Relax all the your muscles, starting at your feel and moving up to your face Breathe in and out through your nose. Become aware of your breathing As you breathe out, say your word silently to yourself When you notice your mind has wandered gently and kindly bring your focus back to your word and your breath Make the time If possible, continue for 5-10 minutes Practice twice daily or when you feel start feeling stress or tension
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