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MASSAGE FOR ELDERS: This "undertouched" market segment is growing rapidly, and presents a real opportunity for massage therapists. But special methods must be used for aging customers. By Joan S. Lohman |
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Willingness to confront our own aversion to aging: In our youth-worshipping culture, it is hard not to equate wrinkles to a loss in value. We constantly witness condescension toward older people. "It's as if," says San Francisco Chronicle columnist Jon Carroll, "those wrinkles equal dead brain cells." I believe condescension is a form of distancing, of pushing away what is unknown or frightening. Bodywork allows us to make contact with the being beneath the wrinkled exterior, to get up close to what may be unfamiliar. An elder body is a map of the personŐs history and genetics. Broken capillaries, age spots, incontinence, and stroke-related speech difficulties are part of the territory, surface landmarks. When I entered the field of elder massage in my early 40s, I had had little experience with elders. As I stood looking into the faces of a circle of 20 old women, many in wheelchairs, and began my first talk on the benefits of massage, I was sweating and apprehensive. The women around me looked so old, their faces deeply furrowed. In the circle, Ida, a 90-year-old retired missionary responded to my presentation of acupressure points. "I always got acupuncture in China," she said. "It kept me going." Reaching out a gnarled, arthritic hand, she asked me to show her self-acupressure. "Maybe it will help my arthritis," she remarked. For 10 minutes, Ida shared her experience of the power of Chinese medicine, as I held acupressure points on her hands and arms. I was so engaged by the depth of her response that I forgot that she was old. This experience with a wizened elder taught me to look beneath the wrinkles, to connect with the human being whose life is reflected in those etched lines. Our conversation was also the beginning of a shift in my attitude about my own aging. Thanks to the many clients who have allowed me to know them through the intimate trust of massage relationships, I am becoming less afraid of getting old.
Respectful communication with each client: How we talk with elder clients may be as critical as how we touch them. Many professionals in the geriatric care field habitually speak to elders in ways that are ageist, disrespectful and patronizing. My teeth grate when I hear my clients called "dear," "sweetie" or "honey." I call my clients either "Faye" or "Mrs. Jones," depending on the client's preference. What we speak about is equally important. Sharon Ellison, founder of Ellison Communication Consultants, conducted a geriatric convalescent unit study analyzing the content of what was said to one patient over 24 hours. The results were shocking. Not once did a care provider speak about an issue that was not related to health, food, practical care or the weather. The patient she was observing was a retired Stanford University professor. Every client has interests besides getting to the next meal and getting to the toilet. I count on meaningful conversation and challenging questions from Rose; I consider her one of my teachers. "Who are your heroines?" she'll ask one week. Another time, "Did you know that Abigail Adams helped write the Constitution?" "Respect," says author Mary Pipher in her groundbreaking book, Another Country: Navigating the Emotional Terrain of Our Elders, "means turning the elderly into elders. We need media that portrays the old as worthy of our time . . . We need cultural stories that point us back to older people as a source of joy and wisdom . . . On an individual level, respect means giving the old time and attention...". Rose hungers for engaging conversation. No one on the staff of the retirement home where she lives approaches her to discuss anything but housekeeping and health issues. One day, after our massage session, Rose turned to me and said, "Thank you for treating me like a human being." Gifts For The Massage Therapist The gift of slowing down: The slower pace of most of my clients invites me to slow down. Even if I have rushed on crowded freeways or race-walked down congested hallways, when I get to my clients' room or they arrive at my office, I attempt to attune my rhythm with theirs. At 103, Thelma was always sitting in her lounge chair when I arrived. I knew, with her limited sight, that I needed to get close before she could see me. She was also hearing impaired, so I would shout when I arrived at her door, "Hello, Thelma! Happy Friday. It's Joan!" and her face would burst into a smile. I would pull a chair next to her, place my hand on her arm, and make contact with her before getting her up, crossing the room slowly, and removing each article of clothing with care for her balance and her frailness. My goal was to respect her pace and her needs rather than maximizing the massage time.
Opportunities to confront our own mortality: Massage therapy with elders offers some of the same rewards and emotional challenges as hospice work. In the 15 years I have served an elder clientele, I have lost over 40 clients to death. While each client's death affects me differently, I have needed to take time to process each loss, either by writing about the client, talking with family members and friends, or simply taking a walk and remembering my connection with the deceased. I remember the day I arrived for 90-year-old Ethel's regular appointment, and found her in bed, lying motionless. She had had an early-morning stroke. I stayed with her until she was taken to the hospital, called her daughter and son, and followed her to the hospital until her family could arrive. During the weeks after her stroke, Ethel had no speech. She had been a nonstop talker and storyteller, notorious for her inability to listen. As I massaged Ethel's stiff shoulders, arms and neck, friends would come, tell her stories and offer best wishes. She could only respond to me and to them with her big grayish-green eyes. "For once in her life, mom's been forced to listen," commented Ethel's daughter, Clair. "The stroke has given her, and us, that gift." In Mitch Albom's best-seller Tuesdays With Morrie, Morrie tells Mitch:
"Aging is not just decay, you know. It's growth. It's more than the negative that you're going to die, it's also the positive that you understand you're going to die and that you live a better life because of it." Each time I leave a client, I am aware that this may be our last session. "See you next week," I say. And, occasionally, a knowing client will respond, "If I'm still here." Appreciation from grateful clients: Many of my clients feel discarded, either by their families or by the culture, simply because they are old. A half hour or an hour of respectful, attentive touch helps them feel valued. One evening I was saying "good night" to a grumpy client who was feeling ill. I took her hand. "I wish there were something I could do to make you feel better," I said. I feel better just because you are here," she responded. "I don't know when the last time was that someone held my hand." As I was stroking Barbara's back during her first massage, she began to weep. I asked her what was wrong. "No one has touched me with this much tenderness since my husband died 10 years ago," she said. She then told me stories about her husband, and thanked me for reminding her that she was still very much alive. Witnessing the harvest of our clients' life's passions: My clients share with me what they have cared about for a lifetime, and their stories give me a sense of connection to their history. Rose grew up on Caruso, Gilbert and Sullivan, and the Bhagavad Gita. She sings from "The Mikado" when I visit. Sarah had a collection of 10,000 classical records that she began collecting as a girl. She played Vivaldi and Mozart as background music to our massages. Plagued with arthritic knees and wheelchair-bound, Ann could no longer travel. She had been an avid bird-watcher and botanist. Whenever I took a trip to Central America or to the Sierra Nevada mountains in California, Ann would ask for a full report of the birds and flowers I had seen.
Benefits Of Massage Therapy For Elders Research indicates that social connection is a key component to health and happiness in the elderly. "Isolation is a powerful risk factor for poor health," according to Successful Aging, which chronicled the results of a MacArthur Foundation Study of Successful Aging. An ongoing relationship with a massage therapist can be a significant part of an elder's support network. The elder knows that at least once a week, she or he will receive the focused attention of a caring individual. Recently, Marjorie, 81, told me, "I woke up in the middle of the night in terrific pain and thought of you. I could relax because I knew you would be coming to see me. I used ice and heat like you suggested, and then I went back to sleep." "Old age is not for sissies," say many of my elder clients. Providing massage therapy to older adults is also not for sissies, yet it is as rewarding as it is demanding. It requires us to have a genuine interest in the lives of elders, to "get over" squeamishness about body functions and physical decline, to be willing to enter the institutional world of elders, and to treat our elder clients with dignity, no matter what their eccentricities or circumstances. One of Rose's comments illustrates why I have stayed in this field for many years now. One day after her massage, we were sitting, facing each other, practicing shoulder stretches to release tight, sore shoulders. "I can feel my flame again," she said, looking at me intently. Then she pointed to her chest. "Your visit has reignited my flame." ••• An AMTA member for more than a dozen years, Joan S. Lohman, CMT, has been providing massage therapy to elders for 15 years. In addition to her massage certification, she is certified in Rosen Method Bodywork, which honors the connections between muscle tension, breath and emotional holding. She leads healing arts exchanges in Central America through Capacitar, an international women's network, whose purpose is to heal and empower through listening to body wisdom. Lohman is currently writing a book:
Touched: Reaching Beneath the Wrinkles. Bibliography Barstow, Cedar. Tending Body and Spirit: Massage and Counseling with Elders. Boulder, Colorado: Cedar Barstow, 1985 (inspired by students at the Boulder School of Massage Therapy). Doress, Paula Brown, Diana Laskin Siegal, and the Midlife and Older Women Book Project. Ourselves, Growing Older. New York: Simon and Schuster, Touchstone, 1987 (written in collaboration with the Boston Women's Health Book Collective). Dychtwald, Ken. Age Power: How the 21st Century Will be Ruled by the New Old. New York: Jeremy P. Tarcher/ Putnam, 1999. Dychtward, Ken and Joe Flower. Age Wave: The Challenges and Opportunities of an Aging America. Los Angeles: Jeremy P. Tarcher, Inc., 1989. Kahn, Robert L. and John W. Rowe. Successful Aging. New York: Pantheon Books, 1998. Pipher, Mary. Another Country: Navigating the Emotional Territory of Our Elders. New York: Riverhead Books, 1999. |
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