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Massage Today
April, 2008, Vol. 08, Issue 04

Serving Elders: Do You Have What It Takes?

By Ann Catlin, LMT, NCTMB, OTR

Working with elders can be a successful area of practice and a personally rewarding experience. It's no secret that this is a growing scope of practice for massage therapists. More and more long-term care facilities are seeing the value of massage for frail elders, those with dementia and the dying. Massage therapists have increasing opportunities to serve this special population. But before you decide to offer your services to your local nursing home, ask yourself these questions: "Am I prepared?" and "Do I have what it takes?" Serving this population requires a unique combination of knowledge, skills and personal awareness.

Be Informed

Knowledge gives you a foundation from which you can act. When you are informed, you can offer your care with confidence and ease. It is essential to be informed about the characteristics and needs of this special population, including:

  • Age-related changes. It is important to understand the "normal" physical and functional changes of aging versus changes that are manifestations of a disease process.
  • Common conditions found in eldercare settings. If you work in long term care, you will encounter individuals living with the effects of stroke, Parkinson's disease, Alzheimer's disease, hip fracture and cancer, among others. A basic understanding of these conditions, precautions and how to modify your approach will ensure that you provide safe, effective and meaningful service.
  • Special needs of elders in facility care. Those who live in care settings often are dealing with loss, grief, feelings of helplessness, lack of control, boredom, touch deprivation and feelings of isolation. Your awareness and compassionate acknowledgement of these sensitive issues will deepen your therapeutic relationship with your client.
  • Benefits and effects of skilled touch. Identifying specific physical, mental and spiritual effects of your touch for those with special needs will help others understand the far-reaching value of your service.
  • How to work within the long-term care system. This can be intimidating if you aren't informed about the way the system operates. Although you may feel confident in your skills as a therapist and comfortable with elders, knowing how to navigate the system is necessary to succeed in expanding your practice to this setting.

Develop Your Skills

Working with elders in facility care requires a set of skills that go beyond massage techniques. While being skilled in massage techniques is important, this work often requires creativity and flexibility because of environmental barriers, positioning needs or communication challenges.

  • Techniques. Some modalities are well-suited for the person living with the effects of aging, disability or dementia, while others are inappropriate. It is important to learn modalities that are safe and beneficial for the variety of conditions and individuals you will encounter.
  • Adaptability. Letting go of techniques and expectations often is called for in order to respond to the needs of your client in the moment.
  • Communication skills. There will be times when your client is unable to speak, or speaks with garbled speech that is hard to understand. Others will be confused or have severe memory loss. Still others will want to share their feelings and stories with you. Many will be hard of hearing. A variety of communication skills are required to relate to the individuals you will serve.

Deepen Your Self-Awareness

Ann Catlin receives an appreciative touch from an elderly patient. - Copyright – Stock Photo / Register Mark Knowing yourself and affirming your own healing presence is perhaps the greatest gift you can offer those you serve. Working with elders will challenge you to learn about yourself and will teach you about the profound nature of service. The following questions reflect awareness that arises if you let those you touch be your teacher and allow yourself to grow from your experience.

What personal gifts do I bring to those I touch? What are my fears about touching the frail or dying person? What are my attitudes and beliefs about aging or death and dying? How might I handle the emotional impact of this work? How can I take care of myself to avoid burning out? Do I have a support system or community of like-minded people with whom I can share my experiences?

Serving elders in your practice obviously is a bit complex, but if you make an effort to be informed, enhance your skills and deepen your awareness, your answer to the questions, "Am I prepared?" and "Do I have what it takes?" will be a resounding "Yes!" and you will be on your way to discovering the rewards of this work. And those elders whose lives you touch will be uplifted by your efforts and, more importantly, by your very presence.


  • Thomas WH. What Are Old People For? How Elders Will Save the World. Acton, MA: VanderWyk & Burnham, 2004.
  • Catlin A. "Sensitive Massage: Reclaiming the Human Touch in Caregiving." 2007. Available at

Click here for previous articles by Ann Catlin, LMT, NCTMB, OTR.


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