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As the population ages and the healthcare crisis is upon us, prevention and self-care practices throughout our life span make both fiscal and physical sense. Chronic illnesses such as those frequently seen in older people--arthritis, hypertension, cancer, asthma, chronic pain--are costly, and symptoms are not eradicated by conventional biomedicine (Ingelfinger, 1977; Bailar and Smith, 1986). Common chronic medical problem in older people may be more effectively treated by a new collaboration among the primary healthcare provider/physician, the specialist(s) of complementary care, and the patient. In addition, because of the frustration with conventional medical practices, many individuals are choosing to take more personal responsibility for their health by exploring a variety of self-regulatory, mind/body, and wellness practices, independence of the physician's input. These practices can be either conventional (such as behavior modification for smoking cessation or weight loss, exercise, rehabilitation groups, risk factor reduction) or "alternative" by today's healthcare standards (e.g., acpuncture, meditation, nutritional counseling, massage). Furthermore, evidence is accummulating that attitudes, stress, feelings of hopelessness, anger, and loss of control all influence our health, our behaviors, and our ability to cope with illness and the frailties of aging. Complementary or alternative care refers to those practices that often come from older, cross-cultural perspectives of health and healing, and that often focus on lifestyle reevaluation and the mind/body interaction. By their very nature, they ar preventive in intention.
This article will focus on complentary or alternative self-care both in terms of collaboration with the primary care physician and individual exploration of self-care0 practics. Definition of these terms is first necessary to create a common language for examining the controversial and often misunderstood options of "alternative" health/self-care. The move to self-care in this country implies a growing need for the individual to be seen as a whole and part of a greater environmental and social syste,. An astute and sensitive health practitioner can help in guiding choices for self-care practices and in setting goals with the individual desiring to take greater responsibility for his or her health. Inherent in the concept of alternative care are notions of personal responsibility and self-care, both of which are implied by the individual actively seeking other ways for healing.
The introduction at the National Institutes of Health of the new Office of Alternative Medicine (OAM), the very successful Bill Moyer's PBS TV series and national best-selling book Healing and the Mind, and a recent article in the New England Journal of Medicine attest to the growing interest in therapies and practices not typically provided by the medical community (Eisenberg et al., 1993). For consistency, this article will use Eisenberg's definition of "unconventional" as "those medical practices not commonly taught at medical schools or available at hospitals in the United States." Since "unconventional," "alternative," and "unorthodox" are pejorative terms, the more positive …