Massage Therapy in Palliative Care

"Music Therapy in Palliative Care" in the October 2008 issue of the Regency Insight for Caregivers discussed the positive effects of music. Next, we take a look at massage, another complementary therapy that can help a caregiver connect with the person who is ill.

For the person who is terminally ill, physical and emotional pain can interfere with quality of life in the last days. The person's healthcare provider, hospice staff and other caregivers can provide medications and other medical treatments for pain and discomfort. Along with medical treatment, non-medical therapies provide comfort and have a positive effect. One therapy that has proven to be very effective during this period is massage.

"Massage" refers to manual muscle and soft tissue relaxation, using a variety of strokes to relieve muscle tightness and pain, to lessen overall stress and anxiety, and to comfort with touch.

The power of touch and contact provides a sense of connection to others, which in itself can be healing. Massage also increases general circulation to the area. It may not only directly decrease pain and tension, but also provide distraction and pain relief in other areas of the body.

Here are some steps professionals may follow when providing a gentle, soothing massage:

1. Begin by determining which areas seem to be holding tension or discomfort.
   
   
2. Make sure the person is in a comfortable position and is physically supported.
   
   
3. Begin with light kneading and/or rubbing the area with a gentle but consistent motion.
   
   
4. The shoulders often hold a great deal of tension. For a shoulder massage, position yourself behind the person and place one hand on each shoulder. Use your thumbs in gentle but firm circular movement across the shoulder muscles. 
   
   
5. The palms of the hands can apply gentle pressure. Talk about what pressure or movement is the most helpful...and adjust the level and focus of pressure in response to feedback.
   
   
6. Hand and foot massage increase circulation to those areas and can provide a sense of comfort and well-being. Gentle yet firm movements can be used to massage the hands and feet, applying light pressure over the knuckles, joints, muscles, palm of the hand and arch of the foot. 
   
   
7. Massage is also helpful in areas of prolonged pressure from sitting or lying. Lightly rubbing and kneading the tissues over the area of pressure increases circulation and promotes healing and the maintenance of healthy tissue.
   
   
8. Using lotion when massaging decreases friction and adds moisture to the skin.
   
   
9. If the person has had difficulty with bleeding or bruising, ask a healthcare provider for guidelines.
   
   
10. Encourage the person to continue to tell you what is the most helpful, and to let you know right away if any motion causes discomfort.