What is Palliative Massage?
November 8, 2023
What is Palliative Massage?
November 8, 2023
Palliative massage is a type of massage where the main goal is relaxation and comfort. It uses gentle, slow strokes and very light touch, and is an approach to client care and not a specific type of massage technique. Palliative massage sessions are comfort-focused and used for frail individuals where the typical physical pressure of a traditional massage is contraindicated.
“Compared to traditional massage therapy, palliative care seeks to help clients just feel better, and not effect a particular therapeutic change or outcome, such as reducing muscle tension, loosening adhesions, or even integration,” says Michael Patrick, LMT, owner at Centered Presence. “It is simply to calm, soothe and comfort."
Similarly, Joseph David Elder, MA, LMT, explains: “Massage therapy for palliative care patients is used for symptom and stress management, comfort, quality of life improvement, support, and relaxation, and not rehabilitation.”
PALLIATIVE MASSAGE BENEFITS AND CONTRAINDICATIONS
Remember, the goal of a massage session with clients who are in palliative care is not to reduce muscle tension, loosen adhesions, or affect therapeutic change in any other way other than to soothe and calm.
“Palliative massage aims to invoke the parasympathetic nervous system,” Patrick says. “It does this in a very gentle, accessible pace that allows clients to receive benefits without inadvertently creating resistance.”
“The main benefit of massage therapy for palliative care patients is comforting touch therapy that can be used to help reduce physical discomfort and existential distress,” Elder says.
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The usual contraindications for traditional massage, such as fever and contagious disease, still apply when working with palliative care clients.
Because massage during these session is typically much lighter, slower, and often only applied to the extremities, however, contraindications most often depend on comfort of the client. Good reminders are to be aware of and avoid any medical devices or tubing, or open wounds.
INTAKE AND MASSAGE SESSIONS: WHAT MASSAGE THERAPISTS NEED TO KNOW
Intake is always important, but especially so when being done for with clients who are seeking massage for palliative care. Massage therapists need a good understanding of the client’s medical history and current status so in order to best tailor a massage session to client comfort and relaxation. Some information on how a client is dealing with their condition can also help, though massage therapists need to ensure they’re clear about their ethical boundaries.
“I still need to know about their medical conditions in a traditional intake, but the emotional component of how they relate to their condition, or how it has affected them emotionally, is particularly relevant,” Patrick says. “Remember, the aim isn’t to fix anything in the therapeutic sense, but at least for the time of the session, to shut down the stress response so that the body’s natural processes can get some airtime.”
The very nature of this work means that massage sessions can vary greatly in length, anywhere from 15 to 90 minutes, depending on how the client is feeling.
Typically, shorter sessions (20 to 30 minutes) are preferred, and decisions around positioning and massage techniques used should be decided upon based on both a client’s preferences and a massage therapist’s best judgment.
“The massage table may be impossible for the client to lay on due to their illness, muscle soreness, or disability,” says Erica Johansen, LMT. “Being flexible is key. Bolsters and pillows may be used to help prop the client into a comfortable position.”
Additionally, massage therapists working with palliative care clients need to be adaptable and willing to meet the client where they are, both in session and location, as many times massage will take place in a person’s home or medical facility, whether hospital, rehabilitation center or assisted living environment.
A typical session will include some type of guided mind and body relaxation practices, gentle touch (such as reflexology or acupressure) for part of the body such as the hands or feet, comfort-focused effleurage, and/or manual lymphatic drainage.
Massage sessions can be done with or without lotion, and many clients will remain clothed. When it comes to technique, the key is to be slow and gentle. “Slow, slow, slow,” says Patrick. “If you think you are going too slowly, you probably could still go slower. Think of it as a snail’s pace, and just as much pressure.”
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Overall, palliative massage is one component of an integrative palliative care plan that can bring relaxation and comfort to clients in need. “Interdisciplinary interventions, such as massage therapy, help manage symptoms while improving a patient’s well-being and quality of life experience,” Elder says.