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Massage Today
February, 2013, Vol. 13, Issue 02

Quiet the Fear and Then Open Your Heart

By Ann Catlin, LMT, NCTMB, OTR

I've had the privilege of teaching hundreds of massage therapists about serving frail elders and people in hospice care. I've learned from these therapists that, no matter what, we all have a few things in common.

We are compassionate, heart-centered people. We want to make a difference in other's lives. And we have a desire to serve people in nursing homes, hospice or home care. But, even massage therapists who feel drawn to this work, struggle with fears and lack confidence in their ability to successfully reach out to this special population. "I don't feel I know enough." "I don't know the proper techniques." "I've never worked in this kind of health care system so how do I get started?" "I'm afraid of the emotional toll it might take on me." I want to challenge you to admit, then let go, of some of your own fears about working with this special population.

There are two themes of concerns that therapists seem to share. (Did you notice I've substituted the word "fear" with "concern"? Feels better already, doesn't it?) One theme centers on questions about how to market your services and how to create clinical programs in long term care or hospice. The second theme has to do with working with these special clients and how to handle situations that arise in say, the nursing home environment. These concerns going to be the focus here.

Your concerns create obstacles. There are obstacles that affect our confidence but, more importantly, obstacles that become barriers to getting in touch with your ability to be a compassionate and therapeutic presence and fully serve your clients. So, how do you go about identifying your own concerns? Try this brief activity as a start. Get a piece of paper. Now, imagine this scenario. Let's suppose you are just getting started with a new position in a large eldercare facility. You have several new clients with a range of conditions and abilities. Three have dementia. One has had a severe stroke. One has advanced Parkinson's disease. Two are non-verbal and spend most of their time in bed. And two are in the facility short term recovering from hip surgery and will be returning home soon. As you get started with your day, the director of nursing asks you to join a staff meeting to introduce yourself and tell them about your work. Okay, now ask yourself, "Is there anything I feel nervous about? Is there anything I don't know if I'm prepared for? If I imagine such and such happening, do I feel a twinge of anxiety or a tightening in my body?" Quickly jot down whatever comes to mind. These reactions represent your personal concerns.

There are four areas of concern that emerge over and over when I do this exercise in my workshops. I will share the most common ones with you here in hopes that you will feel some relief knowing that you aren't alone. The truth is we all have concerns and it doesn't matter how much experience we have. What follows is each of the four areas of concerns and the top three situations that therapists commonly share.

  1. Concerns about interacting with clients, family members or staff.
    • I don't know how I'll do with a non-verbal client.
    • I'm not sure what to say when I first approach a client to start a session.
    • I don't feel confident in how to explain my services to staff or family members.
  2. Concerns about working with people with dementia who have challenging behaviors.
    • What do I do if a client becomes agitated or aggressive?
    • How should I relate to a person who is really confused?
    • What if I can't understand what my client is trying to say?
  3. Concerns about working in the nursing home environment.
    • I don't like the odors and I get squeamish when people's hygiene is poor. What if I have a client like this? Will I be grossed out?
    • I'm afraid I will feel sorry for people and I'll be affected too much.
    • How can I stay focused on my client when there is so much commotion and noise in the nursing home?
  4. Concerns about working with people who are in the dying process.
    • I don't know how to best support the person who is actively dying. What techniques should I use?
    • I'm afraid I won't know what to say.
    • How will I feel after I lose my client? How do I handle my own grief?

We all could add our own things to these lists. I want you to hear that just because you have these thoughts, it doesn't mean that something is wrong with you or that you aren't cut out for this work. It means you're normal and willing to take an honest look at yourself. There is a great little book by Susan Jeffers called, Feel the Fear and Do It Anyway. She tells us to, "accept fear as simply a fact of life rather than a barrier to success. Whenever we take a chance and enter unfamiliar territory or put ourselves into the world in a new way, we experience fear." I like to think of it as finding my edge and then, expanding it.

If you give yourself a break and soften your fears just a little, then you can operate from a heart-centered place rather than being caught up in your thoughts. If we are able to be in the moment rather anticipating what comes next, we are guided in our actions. And if we accept the situation as it is we are able to be fully present to the individual we are serving at the time. After all, at the end of the day, isn't that what it's all about?

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


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