Massage therapy for elder residents: examining the power of touch on pain, anxiety, and strength building

Nursing Homes, Oct, 2003 by Jessica Trombley, Bruce Thomas, Pearl Mosher-Ashley

Chronic pain in the elderly is usually treated with drug therapy. However, alternative therapies have become more widely accepted. One example is massage therapy, which has made progress in aiding drug therapy, and in some cases replacing it, to relieve pain. Because of the direct contact that massage therapy offers, it provides those with Alzheimer's disease a way to relax, thereby reducing the anxiety associated with the disease. Massage also provides stimulation, helping residents communicate physically. This article features the massage therapy programs at the Masonic Home in Charlton, Mass., and The Willows at Westborough, Mass. All residents at the Masonic Home can have a massage, either in a full session or a modified version that meets their needs and accommodates their personal situation. At The Willows, massage therapy is offered to residents in all three living units, with a focus on stimulation. These two profiles of massage therapy programs demonstrate the effects of massage on elders with varying health conditions, specifically those with Alzheimer's disease.

Importance of Massage Therapy

Treating chronic pain in the elder population is especially important because pain is prevalent in most seniors' lives. Nearly 80 to 85% of people past the age of 65 will experience pain caused by a health problem. (1) Of these elders, 25 to 50% will admit to having significant pain, and of those living in nursing homes, this percentage increases to 45 to 80%. (2) The shared experience of chronic pain coupled with decreased social contact at this point in their lives makes massage therapy a particularly effective treatment approach for seniors. Massage therapy reduces the pain of chronic disease and minor injuries, decreases muscle spasms and stiffness, and increases mobility, while providing more physical and social interaction for elders. (3)

For residents with Alzheimer's disease, these benefits also apply, as well as some additional observations. Because massage therapy can be used in two ways, either to relax or to stimulate, it elicits both calming and responsive effects. Massage can alleviate some of the anxiety associated with Alzheimer's by inducing relaxation, but it can also stimulate the nervous system to maintain nerve passageways in decline because of the disease. Touch therapy through massage can offer great relief and even aid the drug therapy that elders with Alzheimer's disease are often prescribed.

Massage Therapy Program at the Masonic Home

The Masonic Home has three living units, including a rest home, in which residents have their own rooms and need minimal care; a nursing home, in which two residents live in each room and need basic care; and a special care unit (SCU) for residents with Alzheimer's. The Masonic Home provides massage therapy to all residents with a doctor's approval. The focus is always on relaxation rather than a strict therapeutic massage because a complete one-hour, full-body massage may be inappropriate for some residents with a lower level of mental or physical functioning. The residents of the rest home can receive the full massage. They make an appointment with the massage therapist and use a private room set up for massage treatments. A hospital bed is used so that transferring is easy, and a bathroom is adjacent for convenient access. The cozy atmosphere of this room, enhanced with music and candles, still follows facility guidelines to ensure that a resident's safety and comfort are maintained.

In addition to music therapy, aromatherapy may also be used to enhance the setting. Aromatherapy is the use of essential oils, either through inhalation or external application, to enhance the benefits of massage by reducing stress, promoting relaxation, stimulating circulation and, in general, awakening the body's and mind's healing energies. (4) Before each massage, the resident chooses an essential oil according to its specific attributes, such as rosemary to increase circulation or sweet marjoram for pain relief. (4) This additional therapy helps to increase the effectiveness of the massage.

Massage Therapy Program at The Willows at Westborough

Massage therapy at The Willows is available for residents in all three units, including the independent living units (The Willows), the assisted living residences (Whitney Place), and the Skilled Nursing and Rehabilitation Centers housed in the Beaumont building. This 11-year-old program focuses on stimulation mainly through weekly one-hour massages. In some cases, the massages are more frequent, and other alternative therapies such as shiatsu, reflexology, tai chi, and yoga are incorporated. These forms of therapy lead to increased strength, better posture and balance and, consequently, to an increased ability and confidence in performing daily activities.

In addition to these direct benefits, the massage therapist often incorporates reminiscence therapy or music therapy as part of the overall experience. Reminiscence therapy is a way of calling the past to mind, particularly positive events, people, or places, to improve elders' outlook on the present by increasing socialization and self-esteem, improving communication skills, and reducing isolation and anxiety. (5) This therapy is used not only by psychotherapists, but also by those in the medical field, e.g., by physical and occupational therapists. (5) According to the massage therapist at The Willows, reminiscence therapy paired with music is regenerative, and thereby changes the self-image of seniors. Listening to music and telling stories stimulate elders to resurrect these memories and focus on what remains. The massage therapist can act as a stimulus by encouraging elders to reminisce during muscle toning.