Does massage therapy belong in the nursing home?
Nursing Homes, June, 1996 by Millie R. Hynes
It is low-cost, low-tech,
and benefits residents and staff
In the interest of improving
quality of life, can alternative medicine therapies such as massage be offered in retirement/nursing homes, especially since
few insurance companies or Medicare pay for them? Yes, it can be done but only with the cooperative efforts of the therapist,
administration, and staff.
I was fortunate to have an
administrator who previously worked at a nursing home where a massage therapist came to the facility on a regular basis. He
said, "I don't exactly know why, but I know people always seemed rejuvenated when they came out of the treatment room." I
provided him with research articles about touch therapies and brought to his attention a growing number of corporations that
include massage as an employee benefit to relieve stress in the workplace.
I worked as a nurse in this
facility. When I explored the possibility of going to a year long massage therapy school, I became acquainted with Dietrich
Meisler, founder of the Geriatric Massage Project, now a national organization. He told me, "With massage, we do not strive
to add years to life but to add life to years." I became a member of the Nurse Massage Therapy Association and joined another
700 nurses nationally who incorporate massage into their nursing practices.
As I circulated around the nursing home, I became aware of how
many residents were experiencing pain, depression, anxiety, immobility, and social isolation. I knew I could not change their
chronic disease or aging process, but I suspected that massage therapy would be an important adjunct to the mission of the
facility - nurturing those we serve by offering them the very best quality life.
Eighteen months ago, we began a massage therapy program in the
facility, available to both residents and employees. Startup costs were minimal - less than $1,080 - because every effort
was made to use items either donated or already in facility storage. My husband assembled the on-site chair from a kit, remodeled
a physical therapy treatment table that had been discarded, and constructed a privacy screen for a fraction of the cost of
buying one. The "tools" of massage therapy are not expensive, the principal ones being the hands of the practitioner.
The success of the program
is reflected in anecdotal data from families, staff and physicians. Two physicians called me personally to express appreciation
for the massage given to their patients, and I receive prescriptions from physicians as they become aware of the service.
One family who lives at a
distance called to report that they "heard a difference" in their mother's voice: "She sounds so much better. Whatever those
treatments are, be sure she continues to receive them." This about a resident who told me on her first appointment, "I am
only here because my granddaughter insisted and I know she thinks I won't do it." (She's
missed only two appointments in the last 18 months.) Another woman, wheelchair-bound, often remarks after
her massage, "My legs were dead and now they are alive!"
Massage is not a cure-all
but implies a compassionate, caring respect for others, and it enables the body to respond so as to heal itself. Research
supports that regular massage over a period of time increases red blood cell counts, serotonin levels and absorption of medications,
and decreases post-surgical healing time.
Residents report decreased
problems with constipation, insomnia, and appetite. Pain is reduced and stress relieved. One resident, a retired nurse with
dementia, had been verbally abusive to other residents. As she came down the hall following her massage, she greeted a group
from her floor with friendly salutations, prompting exclamations of, "What happened to her? Is that who we think it is?"
Often residents with dysphasia
speak in complete and appropriate sentences after a massage. One woman who only muttered continually about "the man and the
thing" said, as she got up from the massage table, "My back feels better but everything else feels funny." A complete sentence,
a new sense of proprioception.
As Juhan writes, "Some of
the most tangible and troublesome features of age itself are simply conditions of muscular activity, activities that bow the
posture and rigidify the joints, that collapse the chest cavity, that put the squeeze on peripheral circulation, that create
all kinds of limitations to movement and that waste precious vitality." Health maintenance and wellness programs like massage
effect the frequency of falls, opportunistic infections, and contractures effecting the elderly's independence to perform
tasks of daily living.
Geriatric Nursing (March/April
1995) featured an article entitled, Efficacy of Hand Massage in Decreasing Agitation Behaviors Associated with Care Activities
in Persons with Dementia, reporting on a study that was done at the University of Minnesota. The author points out that "Although
a number of articles propose interventions for managing agitation behaviors, few studies have systematically explored the
efficacy of specific interventions to promote relaxation and to reduce agitation behavior in persons with dementia."
To substantiate data, as this
study did, is difficult, because the resident's behavior can be affected by the disease process, the time of day, the objectivity
of the staff administering the massage, and many other factors. But what is clear is that massage supports comfort care, implies
a compassionate regard, is non-intrusive, meets the unique needs of individuals, and encourages a
relaxation response that causes a chain reaction of positive benefits.
What about its value to employees?
Nursing assistants, of course, experience a disproportionate rate of back injury. In view of the fact that 8 of 10 Americans
between the ages of 25 and 45 - even the most fitness-conscious - will experience a bout of back trouble at one time or another,
it isn't surprising that the risk increases greatly with any activity that involves twisting, sudden movements and prolonged
lifting. True, massage cannot take the place of exercise in strengthening muscles - but massage can increase flexibility,
body awareness, nutrition of the tissues and softness of connective tissue.
Most importantly, touch provides
a sensation of relaxation, of control over stress. Nursing assistants are under constant
strain with work loads and time constraints. Also, they often enter their jobs each day with frustrations and conflicts in
their personal lives. Massage can help.
Ron Burt, director of a wellness
program for Providence Medical Center in Everett, Washington, created a successful wellness program awarding employees who
participate in such a program a bonus of $250 to $325. Developed in 1991, the program achieved total savings of $369,416 for
1992, at a direct program cost of only $133,700 as a result of decreased health care usage, sick time, and worker's compensation.
I usually see frail residents
for 30-minute appointments, and more robust folks for 45 minutes. At times I will also work on an employee, family member,
or volunteer for a half-hour. I am unable to fit more than six or seven massages into my schedule daily due to my other duties,
such as following up on referrals, documentation, and billing. The revenue from this service, based on residents' and staff's
ability to pay, is $1,900 a month, and I am currently seeking grant monies, facility foundation funds, and other sources to
supplement the revenue generated by the program.
Can you afford to have complementary
therapies that reach out in compassion and empathy in your long-term care facilities? Can you afford not to?
Millie R. Hynes, LPN, LMP, is a licensed nurse massage practitioner
based in Brighton, CO.
COPYRIGHT 1996 Medquest Communications, LLC
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Reflexology and Mental Health
by Simon Duncan
Executive Officer, United
Kingdom Association of Reflexologists
A reflex is a point on the body which, when stimulated, will have an effect on another part of the body. The
classic one is the knee jerk reflex. If you tap the knee, the reflex action is the spasm of the thigh muscles which makes
the knee jerk.
based on the concept that every part of the body is connected by energy pathways which end in reflex areas on the feet, the
hands and the head. Reflexology is the practice of working over these reflexes in a precise and systematic way. By applying
controlled pressure, the body is encouraged to achieve its own natural state of wholeness and good health. Working on the
feet is especially beneficial in clearing and balancing the body.
The concept of
stimulating the body's own healing energies by using pressure points on the feet is not new. It has appeared in many different
cultures around the world and throughout history. Earliest traces have been found over 5,000 years ago in China, Japan, Egypt
and among Indian tribes in the Americas. It spread to Europe in the Dark Ages and forms of "pressure point" therapy were used
in the Middle Ages by both peasants and the aristocracy.
The therapy was
rediscovered in the late 1890's by a Dr. William Fitzgerald and introduced into the United States, arriving in Britain, as
"reflexology", in the 1960's.
mental and emotional benefits of reflexology make it particularly helpful for all stress-related conditions, even when there
is no clinical evidence of disease. By inducing a state of relaxation, tension is eased, circulation improved and toxins released
and eliminated from the body. And as the body's energies flow there is a renewed sense of health and well being on all levels.
Reflexology can benefit, and be enjoyed by, everyone.
For clients suffering
from stress-related illnesses, anxiety attacks, confidence issues or where they may be mentally or emotionally challenged,
reflexology can prove to be a life-altering therapy. Self-esteem and confidence can be enhanced significantly, with recipients
reporting an ability to deal with difficult situations more ably. They can feel stronger and more in control, with communication
improving for some. This often leads to the ability to articulate ideas and express emotions and feelings more readily than
previously possible. There may be a general improvement in being able to feel as well as assess and fulfill needs.
A treatment usually
lasts between half an hour and an hour and, if possible, the client should rest for a while afterwards. Occasionally there
is a temporary reaction as the body rids itself of released toxins. This will not last long and should be seen as part of
the healing process. If there is a reaction, it is wise to eat lightly and drink plenty of fluids.
a reflexologist, it is wise to make sure that the practitioner has been properly trained at a reputable school and is a full
member of a professional organization.
works so well with other forms of treatment, many doctors are finding that referring patients to reflexologists actually saves
patients money. Some participants are able to reduce or stop medication in co-operation with their medical practitioner. People
prescribed drugs or other medical treatment report that reflexology reduces or eliminates side effects, and so enhances the
benefits of orthodox medicine. Before and after surgery, reflexology can stimulate healing so that patients can leave the
hospital sooner and experience fewer complications. Studies have suggested that patients undergoing a course of reflexology
prior to a surgical operation are less likely to suffer from secondary infections as a result of the surgery.
rapidly becoming one of the most popular complementary therapies available today. There are a number of reasons for this:
reflexology is simple, safe and very effective; the patient does not need to undress and the therapist uses only his or her
hands to give a treatment. Although a therapy in its own right, it works well with other forms of medicine, both orthodox
there has been little research into the benefits of complementary medicine, and, in one way, clinical research seems inappropriate
for holistic therapies, which aim to improve the total well-being of the individual, rather than cure illnesses. However,
there have been a number of controlled research projects over the past few years which provide evidence that reflexology has
an effect on the human body and can help to improve various conditions and general health.
Positive research findings also validate reflexology in the eyes of the general public and the medical profession
and so increase public demand. As such there is an upsurge in interest for the development of appropriate controlled research
projects, with a long term view to integrating reflexology with the medical profession to provide healthcare at a more holistic
Association of Reflexologists was founded in 1984 with the aim of setting standards of training in reflexology and providing
a network of qualified and experienced practitioners. Full Members of the Association use the letters MAR after their names
and are included on the Register of Practitioners.
information and a full list of your local reflexology associations can be found at http://www.reflexology.org.
all United Kingdom residents: To receive a copy of the Register of Qualified Practitioners, details of Accredited Courses,
a list of speakers or any other information about the Association or reflexology please send a C5 stamped, self addressed
Association of Reflexologists,
5 Fore Street
Taunton, Sommerset, England TA1 1HX
Tel: 0870 5673320
(Overseas 01823 351010)
Fax: 01823 336646
Or if you are in the
U.K. and have a simple inquiry which is not answered by this article you may telephone the Association's Administration at
0870 5673320 during office hours.
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