Massage for Caregivers
May 29, 2009
Massage for Caregivers
May 29, 2009
I have provided massage to people with cancer for years, and the exchanges I have shared with them have influenced me deeply. But some of my most moving encounters have been with the caregivers of people with cancer. These are family members, friends and partners who, by design or by accident, also are shaped and molded by their experiences as companions to their loved ones.
I meet caregivers when they bring their loved ones into my office. I also meet them at my clients' homes, bedsides and in the hospital. Occasionally, I even see them on my massage table, sometimes for an occasional massage and sometimes for a course of sessions.
Unfortunately, this is not as often as I wish. Caregivers often are the last to benefit from skilled touch in the cancer scenario. When I brainstorm with my students about the benefits of massage for people with cancer, we think up a flurry of ways touch can be helpful to patients. Often a lone voice will ask, "What about massage for family and other caregivers?" And we all quietly nod, remembering people who tend to be forgotten.
Caregiving can be physically exhausting and emotionally draining. It can mean being in a chronic state of emergency. It can require constant vigilance - 24 hours a day, seven days a week - for weeks, months or even years at a time. Imagine being at a sentry post for that long, never relaxing when your world is under siege. The sense of responsibility can be staggering, and rarely is matched by an equivalent amount of control over how things are going to go. Finding ourselves in this disparity, it's natural to be frightened, sad and outraged by the experience. It's no wonder the health risks of caregiving are enormous. Most poignantly, caregiving is isolating. It can be an incredibly lonely experience.
Against this landscape, I've looked for resources in massage therapy and found several. One is a book, A Touch of Hope, by Jana Carrington, who practices massage and teaches Reiki in central Florida. She knows both sides of the experience as a caregiver to her husband through years of cancer treatment, and as a cancer survivor who was diagnosed with cancer within months after her husband's completion of a bone marrow transplant and subsequent remission. Her book is designed for caregivers to read in small increments for self-care tips such as simple reminders to breathe. It's beautifully laid out and possible to draw from without making a commitment to reading the entire book.
I know of two research papers in which investigators looked at the effects of massage therapy on caregivers of people with cancer. The first, by Stephanie Rexilius, et al., appeared in 2002 in Oncology Nursing Forum. The researchers looked at caregivers of patients receiving a stem cell transplant. They recruited 36 caregivers and compared a massage group, a healing touch group and a control group. The massage and healing touch groups received two 30-minute sessions per week over three weeks. The investigators found anxiety, depression, and experiences of burden and fatigue at baseline. Although they did not find statistically significant improvements in the healing touch group, subjects who received massage therapy showed reduction in anxiety, depression and several types of fatigue.
In another paper, Nursing Research, a researcher looked at a more general population - spouses of patients with cancer. Author Linda Goodfellow recruited 42 subjects as part of her doctoral work in nursing. Half were provided with a single 20-minute massage. The other half (the control group) read a book for 20 minutes. In both groups, blood was collected via an IV that had been placed 30 minutes before the procedure. The investigator found improvement in mood and reductions in stress after the massage intervention as compared to the control group, but did not observe effects of massage on natural killer (NK) cell activity, a measure of immune function.
These two studies, while small, demonstrate a spark of interest in the potential for massage to help people's stress during difficult times in their lives. I would caution therapists to quote these studies carefully, without making sweeping claims. Something like, "Small studies suggest that massage therapy might help caregivers of people with cancer" and "Further study is needed to see what the role of massage is in this population," are more accurate than the statement, "Research proves massage helps caregivers."
But the fact that the research isn't quite there yet shouldn't stop us from seeking out work with caregivers. We don't have to wait for the science to support what we already know in our hearts: Skilled touch heals. It eases stress and builds an important bridge between people, easing the isolation of some of the hardest human experiences.
Yes, resources are growing in recognition of caregiver stress. But one of the greatest resources might be massage therapy professionals. Our willingness to listen, the full attention we give to our clients, and the support we provide to others can be powerful. As they give their companionship to others on the cancer journey, so too can they use our companionship.
One of the best resources in this caregiver scenario might prove to be our own hands. There we can comfort, reassure, ease pain, help sleep, shift perspective, validate and support. There we can provide respite, a port in a storm - and where nothing has to be explained, just wordless, quiet support. It will be interesting to find out, in the years ahead, the difference that our work can make.
- Goodfellow LM. The effects of therapeutic back massage on psychophysiologic variables and immune function in spouses of patients with cancer. Nursing Research, 2003;52(5):318-28.
- Rexilius SJ, Mundt C, Erickson Megal M, Agrawal S. Therapeutic effects of massage therapy and handling touch on caregivers of patients undergoing autologous hematopoietic stem cell transplant. Oncology Nursing Forum, 2002;20:E35-44.