Developed by the Complementary Therapies Team at St Christopher’s Hospice

Use of Touch & Simple Massage

Touch

We use touch in many ways when caring for people. Often it is a necessary part of achieving something practical, such as helping someone to get washed & dressed or to give an injection, & may not always be seen as welcome or pleasant.

But touch is also a fundamental and very important means of human communication. We all need touch as part of our lifelong need to be nurtured, valued & cared for, but sometimes when people are elderly or sick, they can become starved of touch for many reasons. When we think about how we touch our own loved ones – partners, parents, children etc – we can see how a simple touch can often convey care, compassion & empathy in a way which may be difficult with words alone.

So when & how can we include this kind of therapeutic touch into the professional care that we give to clients & to their families?

  • If a person is anxious or agitated, your gentle touch can be very calming, relaxing & soothing.
  • If a person is sad, lonely, it may be difficult to know what to say, but your touch can show empathy & caring, & may comfort them & ease their pain.
  • If a person is feeling depressed, isolated or worthless, then your touch can show them that they are valued & cared for.

Not everyone likes to be touched & every situation is different, so it may depend on your relationship with that person & on you reading cues from their body language, their behaviour & what you already know about them.

  • It may be as simple as just holding their hand or gently touching a shoulder, or it may be that you could include some basic massage into their care.
  • This may be something you can include in the care you already give your residents in the care home – such as a hand massage at the end of a bed-bath, gentle leg massage whilst in the bath, or maybe a brief foot massage to promote sleep when being settled down for the night.
  • For a distressed relative, you might offer to massage their hands when words just don’t seem enough.

Hand Massage

Hands are hard-working parts of the body, so it is deeply comforting to have them massaged. It needn’t take long & is less intrusive than massaging anywhere that needs to be undressed. You don’t have to be a qualified therapist to give a simple, gentle hand massage – just using gentle stroking movements (nothing deep or manipulating). The movements stimulate the circulation of the blood, warming the hands & helping muscle tone. Thousands of nerve endings in the fingers & palms increase the calming, relaxing effects of a hand massage on the whole body & the emotions, making the person feel cared for and nurtured.

When NOT to give Hand Massage

On broken, weeping, infected or highly sensitive skin.

If the person has a new pain there, not yet assessed by a doctor.

Tips for giving a Relaxing Hand Massage

Make sure the person is in a comfortable, well supported position.

Support their hands in a natural position using pillows or cushions.

Position yourself facing &/or side-on to them so that you can comfortably hold the hand without stretching either their arm or yourself.

Oil or creams are not essential but will help to give better massage by gliding over the skin & moisturising it - especially on dry, mature or fragile skin.

About 5mls oil (eg sweet almond) or a 10p size blob of lotion should be enough. Plain lotions such as Aqueous cream, Diprobase, E45 are fine. Or the person’s own hand cream - just try to avoid anything very highly perfumed on dry or sensitive skin.

But remember! If no oils/creams are readily available - don’t lose the moment by going off to search for them!

It’s useful to use a towel under the hands, to catch any surplus oil & to wrap the hand you’re not massaging – (but again, not essential if it means you losing the moment with that person).

Let the person know that they can talk if they want to, but that it may be best to just relax & be quiet, perhaps with their eyes closed. Try to avoid chatting to them during the massage if possible.

Techniques You Might Use

Below we give you suggestions for a routine, but remember there is no one set way to give a hand massage! You will adapt it to each person & each situation.

The important things are to:

Keep it comfortable for both of you.

Keep it at a gentle, even pressure (not deep, but not ticklish either)

Keep it at a slow, rhythmic, relaxing pace.

Suggested Routine for a Simple Hand Massage

Warm your hands & the oil first by placing it on your palm & rubbing your hands together.

Gently take hold of one hand & sandwich it between your palms, to warm it & to introduce your touch.

Back of Hand

Continue to support the hand resting on your palm whilst stroking the whole of the back of the hand, sweeping up from fingertips to wrist & sliding fingers slightly underneath on return.

Then support hand with both of yours - using your fingers underneath to support it, leaving your thumbs free to work on the back of the hand.

Wrists - gentle circles around the joints.

Back of hand - stroke across with sweeps of your thumbs.

Back of hand - small circles all over with your thumb.

Back of hand - stroke gently up the grooves between the bones.

Fingers - using one hand to support the palm, hold each finger & thumb in turn between your finger & thumb, & work down it from knuckle to fingertip with gentle circles.

Fingers - return to the finger or thumb you started with & with a very gentle squeeze, slide from the base of each finger/thumb to the tip. Do not pull on the fingers - you should not hear any joints clicking!

Sandwich the hand between yours again to gently turn it over.

Then repeat similar routine on palm of hand:

Stroke the whole area with a sweep from fingertips to wrist with your palm.

Wrists – gentle circles around joints.

Palm – stroke across with sweeps of your thumbs.

Palm – small circles all over with your thumb (especially into the fleshy pad of their thumb).

Palm – strokes in lines from bases of fingers up to wrist.

Fingers – as before, gentle circles down each, between your finger & thumb.

Fingers – as before, very gentle squeeze & slide down each one.

Stroke down whole area from wrist to fingertips with the flat of your palm, gently straightening fingers only as far as they go naturally & comfortably.

To finish:

Sandwich the hand as before to turn it over again - their palm resting down.

Stroke whole back of hand as at the start – (palm sweep from fingertips to wrist).

Gentle stroke as you replace the hand to rest in a comfortable position – cover it with yours for a few moments before breaking contact.

If possible, fold the towel over it to keep it warm whilst you massage the other hand.

 Repeat same routine on the other hand.

Remember these are only suggestions! The main thing is to maintain a gentle, caring touch throughout, so that you will leave this person feeling calm, cared for, and relaxed.

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Touch & Simple Hand Massage