UpClose & Personal - Complementary Therapies

While I was in training to be a massage therapist I observed that many of my classmates expressed a desire to not have elderly clients in their practice. Since I had a number of elderly clients among my volunteers that received complementary training massages, I soon realized that I enjoyed working with the elderly. Also, if other massage therapists were not recruiting elderly clients they were a ready population for my practice. Hence, I specialized in geriatric massage during my training and have a practice with a high percentage of elderly clients. I work in two assisted living facilities doing chair massage and see many elderly clients in my clinic for full body massage.

I like working with older clients because most of them are very appreciative and express themselves in letting me know what their needs are and if I am helping. Most of my elderly clients tell me that they are lonely and feel isolated. They like massage because it relieves some of these feelings and makes their lives better. I am conscious of this and try to build rapport with each client with the intent of improving their psychological state of mind. An important part of building rapport is my sincerity in listening and showing concern by asking questions that allow them to express whatever is on their mind. If I do well they quickly show signs of reduced stress and relaxation as well as decreased anxiety and fear. As their psychological state improves, their readiness to receive a good massage improves. In the process of rapport building I find I have to show a lot of patience. Elderly clients move slowly, take longer to unbutton and button buttons, to dress and undress. I also have to hold a sheet as a drape while they are undressing and dressing and then help them on and off the table.

As I start the massage I evaluate each client's physical condition for a massage. I find some are quite hardy and can enjoy fairly strong pressure, while at another time or with another client I need to use lighter, more soothing pressure. It is likely that the pressure may need to be varied more for elderly clients than for younger clients. Hence, I select the pressure and the massage approach according to the needs of each client at each massage. Much of the technique I use will be swedish massage or a modification of it. However, when appropriate I use some deep tissue, neuro-muscular, myo-facial release, lomi lomi, sports massage and the side posture of pregnancy massage.

With experience I have become aware of body parts where most geriatric clients like to have extra massage. I find the hands, feet and back are most appropriate for extra attention. The hands are generally very sensual and often feel cool, hence, I take time to warm them recognizing that a gentle hand massage lessens anxiety and promotes relaxation. During this time I may be able to do some reflective and interpretative feedback that acknowledges the clients communication which helps fill their needs for companionship and to be touched. I am always looking for activities that add quality to their lives. When I do the feet I ask if there are any sensitive areas. I always give the ball of the foot special attention and stroke to widen the foot. This is relaxing and gives a wider base for walking which is helpful to an older person. On the lower back I use my palms and fingers on each side of the sacrum, then use push/pull and circular strokes. I also place my hands on each side of the lower back and do light rocking strokes.

Many of my elderly clients are quite inactive. This inactivity may be due to stiffness, joint pain, fear of falling or lethargy. When a client can profit without injury I use active isolated stretching to increase flexibility, increase blood flow and lymph flow, improve balance and enhance a feeling of general well being to counteract the lethargy. I often use the straight leg hamstring stretch [neutral, inner, and outer], a groin stretch from the inner hamstring position and the piriformis [femoral attachment] stretch shown in the book, Active Isolated Stretching: The Mattes Method, written by Aaron L. Mattes. I also teach hip flexion where the client lies in a supine position and pulls the bent knee up toward the armpit on the same side. This is a stretch that helps the upper legs, hips and lower back muscles and can be done by the client without assistance. I have clients in the 80's and 90's doing these stretches while lying in bed, often before they get up in the morning. If the client cannot do these stretches, I encourage leg lifts while sitting on the edge of the bed.

Another massage technique that is very popular with my clients is clockwise abdominal massage. This stimulates the abdominal organs and encourages solid waste elimination from the large intestine. Again, I teach my clients to do this themselves so they can do it at their leisure. I like to have my clients do the activities themselves that promote their health and body functions. This gives them a feeling of participation, and thus helps them to be more vigorous and independent.

I thoroughly enjoy my work as a massage therapist and I especially enjoy my work with the elderly. Also, I would be remiss if I did not mention that I am a proud owner of a Golden Ratio Woodworks massage table and chair, which have given me years of reliable service and are a joy to use.

BIO

Leo J. Kelly

Current License: LMT–State of NE
Owner and therapist in:
Kelly's Massage Therapy
602 N 9th Street
Beatrice, NE 68310

Highest Education: Ed.D. in Special Education and Psychology

Retired form Valdosta State University,
Valdosta, GA as Callaway Professor of
Special Education Emeritus in 1985

Military: 1943-1946 –Navy –BM2C –Served aboard CVE 93, USS Makin Island