Institute for Integrative Healthcare Studies

Institute for Integrative Healthcare Studies

February 10, 2009 /

Geriatric Massage – Part I

There are currently more than 35 million Americans over the age of 65, and geriatric massage is one of the fastest growing specialties in the area of massage therapy. Discover eight specific medical issues you may encounter with this population – including skin ulcers, impaired hearing and chronic conditions – and how these issues may impact your massage sessions. In this exclusive 2-part article, you'll also learn how you can help ease the aches and pains of our aging population.

by Linda Fehrs, LMT

When we come into this world we are, for the most part, touched, held and coddled by family and friends. Everyone loves a baby and wants to be a part of this new life. At the end stages of life it is more likely that there are few eager to embrace a fragile body or address a weakening soul. Often the elderly and frail are all but shunned at a time when they should be most included in our lives. They are by some accounts the most “under touched” of our society.

As a massage therapist you are trained to provide what an elder or frail individual may need the most. While others may provide meals and other physical comforts, you can offer the essential gift of compassionate and healing touch.

The first of the baby boomers (those born between 1946 and 1964) are beginning to hit their 60s, an age when they will be officially classified as senior citizens. And it seems that for the most part they are a hale and hearty bunch. Brought up in a world of eclectic approaches to health, accepting as normal the practices of yoga, meditation, therapeutic massage and the consumption of organically grown foods, they benefit from advanced medical technology as well as many modern conveniences that make life easier. They are also the first generation to be brought up in a culture providing them with highly processed prepackaged foods, toxic air, water pollutants and the stress of high expectations.

8 Medical Issues and Massage Implications
Those born earlier, in the 1920s – 1950s, are living longer which, when combined with baby boomers, means the field of geriatric massage will only increase proportionately to this growing population. While serving this segment of the community might at times be challenging, it can be very rewarding. If you are focused on a geriatric population in your practice, you may have a large age range of clients, which means a need to be knowledgeable about a wide spectrum of medical issues.

There are some specific issues you may have to deal with in an aging client population. Here are eight examples of issues you may encounter along with ways you can make the massage session easier for both of you:

1. Hearing / Vision Loss – Allow more time for intake. A person with hearing or vision problems may take longer to fill out your forms. You may want to offer a large print format or suggest the intake be conducted in an interview style, which would lessen the chances of mistakes or misinterpretation of information.

2. Less Mobility / Agility – Make sure your office is handicapped accessible and, if needed, provide some sort of a sturdy step up to the massage table as well as a helping hand. If mobility is a major problem you can offer seated massage rather than one on your table.

3. Medications – Become familiar with common medications such as those used for high or low blood pressure, blood thinners, cancer treatments, heart problems and psychiatric problems. The absorption rates and side effects of many medications are affected by massage and, if not taken into consideration, can lead to dizziness, nausea, increased lethargy and/or bruising. Pain medications may make your clients less sensitive to touch or unable to give accurate feedback regarding appropriate pressure during a massage. Check with the primary physician if you are unsure about any medications your client may be taking.

4. Past Surgeries and Injuries – As one grows older they most likely have had some serious injuries or surgeries, such as joint replacement. Often, special bolstering or positioning is important for the client’s comfort and safety.

5. Common Diseases – During intake, make note of ailments like Crohn’s disease and diabetes, bronchial problems like asthma or chronic obstructive pulmonary disorder (COPD) and cancer. Be alert to these and other common conditions, as they will most likely affect how the massage is conducted.

6. Chronic Conditions – Gastrointestinal problems are common. As we get older our digestive tract often becomes less effective. The intestinal and abdominal musculature weakens and nutrients are absorbed less efficiently. Problems can vary from mal-absorption disorders, to diarrhea and constipation. Incontinence may be a concern because of kidney or urinary bladder deficiencies. Other organs slow down and become less productive. Still more problems may arise with the removal of dysfunctional organs like the gallbladder or spleen.

7. Skin Ulcers (commonly known as bedsores) – Skin ulcers are common among those who are forced to remain immobile for long periods of time. This can be easily avoided by moving the client to new positions regularly and by massage.

8. Psychiatric Problems – Various forms or dementia, such as Alzheimer’s disease can make giving a massage challenging. Depending on the severity and stage of the illness, clients may not comprehend what is happening and patience is needed to help them understand. Other clients may suffer from depression or anxiety, in which case a massage may help them to relax and feel more in control of their lives.

Offering Comfort and Influencing Health
The older one gets, the more things start to break down. The skin becomes thin and fragile, muscle tone and mass decrease and bones become more brittle. These are things to take into consideration when dealing with the elders in a massage setting. Whether it is providing them with a soft fleece pad to lie on while receiving a massage, an extra blanket for warmth or simply comforting them with friendly conversation, massage therapists can offer a welcoming and healthy atmosphere.

If a person is frail or ill, other than being poked and probed for medical care, they are often deprived of the very essential basic touch. Other family members are on the go, busy with their everyday lives. Their spouse may have died or be incapacitated. Children and grandchildren have moved away and old friends may be too ill to visit. There is often no one close to have warm, intimate or friendly physical contact with. Whether remaining at home or living in a facility, seniors can become socially isolated, depressed and lonely.

Some may be healthy and strong at 90, others may be frail and sickly at 50 and seem more “senior” than their elders. Active seniors may be healthy enough to come to your office for a massage, but in many cases you will find you must visit their home, hospital, assisted living facility or even hospice. No matter what the location, you may find that you need to provide some special accommodations to assure comfort and safety.

This emergent senior population will have a huge impact on our healthcare system, and massage therapists can have an equally large impact on influencing their health.

Recommended Study:
Advanced Anatomy and Pathology
Pharmacology for Massage

References:

Nelson, MFA, CMT, Dawn. Compassionate Touch: Hands-On Caregiving for the Elderly, the Ill and the Dying. Barrytown, New York: Station Hill Press, Inc., 1994.

Nelson, Dawn. From the Heart Through the Hands: The Power of Touch in Caregiving. Forres, Scotland: Findhorn Press, 2001.

Rose, Mary Kathleen. “Comfort Touch: Nurturing Acupressure Massage for the Elderly and Ill.” December/January 2004. Associated Bodywork and Massage Professionals. 14 Oct 2008

Wible, RN, BSN, Jean. Pharmacology for Massage Therapists. Baltimore, Maryland: Lippincott Williams & Wilkins, 2005.