Finding out what each client needs
Eli* was a retired university professor . He was very well educated and always wore a suit jacket while sitting in his wheelchair. Diagnosed with dementia, with his family living out of the area, Eli was forced to live in a nursing facility. One of the worst ones that I visited on my rounds as a hospice massage therapist. For the most part, Eli was unresponsive but when he did speak it was one word sounds or a breathy “yes” or “no.” He didn’t interact with anyone other than our hospice staff and, when needed, facility nurses. Other than feeding, changing his diaper, and bathing him, he did not receive any touch or was there no interaction. There was no planned activities within the dementia unit of this particular facility. The aides would put all the residents in front of the TV, usually on some obnoxious mid-day show while they, in turn, would go sit in the back of the day room and play on their phones. It was heart-wrenching to witness.
I loved to go see Eli. Knowing his background as an intelligent, respected professor who was stuck in a body that wasn’t working anymore, I would push his wheelchair down to what I called the garden room (picture a larger room with hardly any furniture, a wallpaper mural of a garden pond and large windows looking out on a wooded area.
I would put the classical music station on speaker from my phone and start the massage session by putting my palm on his cheek. His eyes would gently close and his face would change instantly.
Touch deprivation? What is that?
We’ve read stories about orphans in Romania that were left unattended and untouched, https://www.washingtonpost.com/local/romanian-orphans-subjected-to-deprivation-must-now-deal-with-disfunction/2014/01/30/a9dbea6c-5d13-11e3-be07-006c776266ed_story.html
While this is an extreme example, there are a multitude of studies done by universities all over the world. Tiffany Field’s, Touch Research Institute out of the University of Miami, being a leader in that research. It was found that teenagers in America touch each other less are more aggressive towards their peers than teens in France or Puerto Rico. For more information look here or more specifically here
In the May 2014 article “Are you touch deprived?” written on the health24.com website, it’s explained that
“touch, or the lack of it, affects us all. Healthy touch slows our heart rates and reduces anxiety. It makes us feel safe and nurtured. A lack of touch, though, can make us feel very lonely, depressed, ill and even aggressive and angry at the world.
Touch helps to increase oxytocin and minimizes stress hormones. This in turn helps to increase our immune system and fosters a sense of well-being. Look at how stress effects our immune system here.
What happens during a hospice massage session
People look at me funny or at least with a confused look when I tell them what I do. Massage, massage table, getting undressed, deep tissue? On the dying?
No, nothing like that at all.
Wherever my client is when I get there, I let them remain there. For instance, if they are in their wheelchair, they stay there. If they are in bed, all the better. Moving a person who has no, or hardly any muscle control, is usually a two-person effort and can take much time and effort. And more importantly, transfers from wheelchair to bed are when a lot of accidents occur. Not only that, but it is a huge amount of strain on the elderly client. Therefore, I let them stay wherever they are.
Sitting in a wheelchair, sometimes napping for hours in one too, can cause tremendously stiff and tense muscles in the upper back and neck regions of the body. Sitting, not moving, and not being touched for long periods of time can have all sorts of emotional, physical and mental effects. The goals that I start most sessions with are to increase comfort, care, and circulation. I want to increase the relaxation response in the body by shifting the nervous system to have a more parasympathetic response rather than a sympathetic response. This will change the body’s environment and allow the affect of the session to last long after I leave. Using specific massage modalities, energy work and good old fashioned hand holding helps to do this.
Eli loved his sessions. I would work on his very stiff neck muscles while gently resting his forehead in my other hand. My massage teacher would call this method ‘the mothering hand’, gently placing the non-working hand on an area of the body to convey safety and security. With Mozart in the background, a peaceful, quiet room without a loud TV on, and nurturing touch, he was able to reconnect in ways that are very deep and not able to measure.
Being present with him, being intentional with my touch, is most important. Listening with my fingers to feel tension release or contraction happen from pain. Watching with my eyes to see his face change and his chest rise with a calming breath. This is what is meant by intentional touch, and in my opinion, the key to reducing touch deprivation most.
If you work with the elderly or are lucky enough to have an older family member present near you, the next time you spend time with them, hold their hand with intention or with care and gentleness rub their back. Don’t be afraid to touch them, they need it desperately. See the joy that comes to their face, the calm that comes over with a deep breath. Know that you are doing great work just by touching and being with them.
*name changed to ensure confidentiality