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The Elderly

Benefits of Massage for

Special Populations

The Terminally Ill

The Elderly

The Terminally Ill

Palliative Care

5.05.2023

Benefits for the Elderly

- Reduction of Stress

- Improved Mental Outlook

- Increased Blood Circulation

- Better Sleep

Benefits

Categories of Elders

Categories of Elders

Robust Elders: show few signs of impaired health, often look younger than their chronologic age

Age-Appropriate Elders: show some of the typical signs of aging, will have some problems associated with aging. Limit the prone position to 15-20 minutes

Frail Elders: look and feel fragile to the touch and need special care. Be sure to check with their doctor first. Limit the session to 15-20 minutes

Massage Techniques

Massage Techniques

Techniques of Effleurage and Petrissage; enhances blood circulation, relaxing the muscles, and keep connective tissue pliable

Joint movements and stretches; improve walking, climbing stairs, getting dressed and undressed, and help maintain normal range of motion in the head.

Abdominal massage for the viscera, which may benefit those that are sedentary to improve digestion and elimination.

Reduced Pressure and Reduced Sliding Force

Allow for Flexible Time Blocking and Shorter Sessions

Positioning

Positioning

Semireclining Position Advantages:

- Easier for the Client to get in and out of

- A good option for those with trouble breathing or feeling lightheaded when getting up

- Can be more sociable, making eye contact

Disadvantages:

- Limits access to different areas of the body

- Body mechanics for massage therapist needs some creativity

Cautions

Cautions

- Contraindications with medications

- Thin skin; prone to bruising. Reduce pressure and apply enough lotion to prevent skin tearing

- Varicose Veins: use light effleurage and jostling

- Atherosclerosis: which is hardening of the arteries. Use caution especially with the neck

- Use caution if they have ankle edema.

- Use caution when working around artificial joints

- Check with a physician to make sure a massage session isn't a contraindication

Benefits

Benefits

- Relieving Pain

- Reducing Nausea

- Reducing Depression & Anxiety

- Alleviating Lymphedema

- Helping to prevent Neuropathy

- Easing of Fatigue

Care Goals

Care Goals

- General relaxation

- To improve circulation of blood and lymph.

- Reduce muscular tension

Massage Techniques

Massage Techniques

- Sessions should be softer, gentler, and shorter; usually around 10 to 20 minutes of contact.

- Quality of touch should be gentle and simple techniques such as stroking and holding with a smooth and soothing touch.

- Intuition and sensitivity to others are important qualities

Important Skills

Skills

- Sensitive massage

- Active holding

- Listening and feedback

- Visulization and guided meditation

- Shared breathing

- Remain flexible and creative

- Massage Therapist practice self-care

- Communication with health teams

Cautions

Identify contraindications and cautions before proceeding with a session.

Cautions

Scope of Palliative Care

Scope

Emphasize quality of life, comfort rather than cure.

Can be part of treatment with curative intent and not restricted to people receiving end of life care

Five Stages of Palliative Care

5 Stages of End of Life Care

1. Creating a Plan

2. Preparing Emotionally

3. Early Stage Care

4. Late Stage Care

5. Supporting your love ones

Goal of Palliative Care

Provide relief from pain and other symptoms of a serious illnes

Goal of Palliative Care

History

History

- Grew out of the Hospice movement in the 1960's

- In 1987 Declan Walsh established a palliative medicine service at the Cleveland Clinic Cancer Center that evolved into the Harry R. Horvitz Center for Palliative Medicine becoming a international demostration by the WHO

- Accredited by the European Society for Medical Oncology as an Integrated Center of Oncology and Palliative Care

Benefits

Benefits

New England Journal of Medicine study found Palliative Care with Oncolgic care showed lower rates of depression, increased quality of life, and increased length of survival compared to those without.

Archives of Internal Medicine found significant hospital/health system cost savings

References

References

- New England Jouranl of Medicine

- Doug Levine, LMT, AMTA

- Archives of Internal Medicine

- National Hospice & Palliative Care, Hospice Care in Amercia 2014

- Cochrane Database of Systematic Reviews 2022

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