Continuing with the steps presented in the last post, here is the next series of steps for massaging geriatric clients.

Turn client over slowly to Supine position.

1.      From top of table - Effleurage chest and neck.

2.      Gentle alternating push on shoulders.

3.      Slow fingertip pulling up both sides of neck.

4.      Fingertips circles over Pectorals, Deltoids, Lavetor Scapula and up the neck.

5.      Continue circle behind the ears and onto the scalp.

6.      Effleurage forehead.

7.      Circle temples.

8.      Gentle fingertip pressure over cheeks.

9.      Masseter circles.

10. Jaw Effleurage.

11. Ear Massage.

12. Feather stroke over forehead.

Move to side of table.

1.      Effleurage entire arm and hand.

2.      Thumbs circles on back of hand.

3.      Thumb stripping between metatarsals.

4.      Thumb circles over palm of hand.

5.      Thumb and fingertip circles on both sides of wrist.

6.      Massage fingers.

7.      Gentle thumb stripping up both sides of forearm.

8.      Fingertips circles around elbow.

9.      Knead Biceps.

10. Fingertips circles around shoulder joint.

11. Support and lift arm to gently knead Triceps.

12. Milk down the forearm.

13. Final effleurage the entire arm.

14. Repeat all steps on other arm.

Undrape the abdomen.

1.      Effleurage abdomen.

2.      Gentle thumb pressure to open diaphragm.

3.      Clockwise circles.

4.      Petrissage and rake opposite side.

5.      Transition to other side following the rib line.

6.      Petrissage and rake opposite side.

7.      Clockwise circles.

8.      Fingertips vibration over colon pathway.

9.      Wringing.

10. Final Effleurage and cover.

 Undrape one leg.

1.      Effleurage entire leg.

2.      Petrissage and wring entire leg.

3.      Execute proper draping procedures and bend knee with foot flat on table.

4.      Palm stroke up the calf.

5.      Palm strokes up thigh.

6.      Fingertips circles down the thigh.

7.      Fingertips circles down the calf.

8.      While placing the leg back down – fingertips circle on back of knee.

9.      Light thumb circles on front of knee.

10.  Heart the knee.

11. Final Effleurage.

12. Massage the foot. (same as Swedish routine)

13. Repeat all steps on other leg.

The benefits of Geriatric Massage

Geriatric Massage can help the aging with:

1. Stress relief and relaxation
2. Better circulation
3. Overall improvement of bodily systems function
4. Improve skin elasticity and vitality
5. Alleviate depression
6. Increase self-esteem
7. Increase mobility and flexibility
8. Pain relief
9. Improve memory
10. Increase vitality

Furthermore, geriatric massage helps reduce high blood pressure, alleviates lymphedema, and diabetic complications. Geriatric massage also helps stroke patients, circulatory disease and patients suffering from Parkinson’s, MS, Alzheimer’s, Sleep disorders, emphysema, joint replacement, amputation, arthritis, bursitis, and even tendonitis.

Contraindications--physical conditions in which massage may not be advised.

In most cases, client’s physician will be consulted ahead of time regarding massage. In general we are going to use lighter pressure and no heat.

1. Heart problems, Circulation problems, Osteoporosis, Diabetes, and Arthritis - Avoid deep work or percussion movement.   
2. Fractures or Post-operative – Need longer time to heal, consult with doctor.
3. Thrombosis, Phlebitis, Arthrosclerosis, Infections, Inflammations and Numbness - Avoid the area.
4. Ulcers, Prostatitis – Avoid abdomen.
5. Fever – No massage.
6. Seizures – Consult with physician.

The most significant changes in organ reserve occur in the heart, lungs, and kidneys. The amount of reserve lost varies between people and between different organs in a single person. These changes appear slowly and over a long period of time. Even so, when an organ is worked harder than usual it may not be able to increase function. Sudden heart failure or other problems can develop when the body is worked harder than usual. Things that produce an extra workload (body stressors) include the following:

• Certain medications
• Illness
• Significant life changes
• Suddenly increased physical demands on the body, for example:
  • A sudden change in activity
  • Exposure to a higher altitude

Loss of reserve also makes it harder to restore equilibrium in the body. Drugs are detoxified at a slower rate. Lower doses of medications may be needed, and side effects become more common. Medication side effects can mimic the symptoms of many diseases, so it is easy to mistake a drug reaction for an illness. Some medications have entirely different side effects in the elderly than in younger people.

AGING THEORY

No one really knows how and why people change as they get older. Some theories claim that aging is caused by accumulated injuries from ultraviolet light, wear and tear on the body, by-products of metabolism, and so on. Other theories view aging as a predetermined, genetically-controlled process.                   However, no theory sufficiently explains all the changes of the aging process. Aging is a complex and varied process that varies in how it affects different people and even different organs. Most gerontologists (people who study aging) feel that aging is the cumulative effect of the interaction of many lifelong influences. These influences include heredity, environment, cultural influences, diet, exercise and leisure, past illnesses, and many other factors.             Unlike the changes of adolescence, which are predictable to within a few years, each person ages at a unique rate. Some systems begin aging as early as age 30. Other aging processes are not common until much later. Although some changes typically occur with aging, they occur at different rates and to different extents. There is no reliable way to predict specifically how you will age.

THE AGING PROCESS

All vital organs begin to lose some function as you age. Aging changes have been found in all of the body's cells, tissues and organs, and these changes affect the functioning of all body systems. Living tissue is made up of cells. There are many different types of cells, but all have the same basic structure. Tissues are layers of similar cells that perform a specific function. The various kinds of tissues group together to form organs.

There are four basic types of tissue:

• Connective tissue supports other tissues and binds them together. This includes bone, blood, and lymph tissues in addition to the tissues that give support and structure to the skin and internal organs.
• Epithelial tissue provides a covering. The skin and the linings of the various passages inside the body are made of epithelial tissue.
• Muscle tissue includes two types of tissue:
  • Striated muscles, such as those that that move the skeleton (also called voluntary muscle)
  • Smooth muscles, such as the muscles that surround the stomach
• Nerve tissue is made up of nerve cells (neurons) and is used to carry messages to and from various parts of the body. The brain is made of nerve tissue.

AGING CHANGES

Cells are the basic building blocks of tissues. All cells experience changes with aging. They become larger and are less able to divide and reproduce. Among other changes, there is an increase in pigments and fatty substances inside the cell (lipids). Many cells lose their ability to function, or they begin to function abnormally.                                                                                                                     

Waste products accumulate in tissue with aging. A fatty brown pigment called lipofuscin collects in many tissues, as do other fatty substances.         

 Connective tissue changes, becoming increasingly stiff. This makes the organs, blood vessels, and airways more rigid. Cell membranes change, so many tissues have more trouble receiving oxygen and nutrients and getting rid of carbon dioxide and wastes. Many tissues lose mass. This process is called atrophy. Some tissues become lumpy (nodular) or more rigid.                                           

 Because of cell and tissue changes, your organs also change as you age. Aging organs gradually but progressively lose function, and there is a decrease in the maximum functioning capacity. Most people do not notice this loss, because you seldom need to use your organs to their fullest capability.                          

Organs have a reserve ability to function beyond the usual needs. For example, the heart of a 20-year-old is capable of pumping about 10 times the amount that is actually needed to preserve life. After age 30, an average of 1% of this reserve is lost each year.  

INTRODUCTION

Geriatric Massage, also known as Massotherapy, is a form of massage designed to meet the specific needs of the elderly population. It aims to treat the whole person and not just the condition they have. This technique involves the use of our hands to manipulate soft tissue to improve blood and lymph circulation, relieve pain, and increase range of motion.

Active or passive movement of the joints may also be a part of geriatric massage.

As we get older, our body suffers from a variety of age-related diseases like Parkinson’s disease, arthritis, diabetes, or heart disease. As a result, we have poor blood circulation and limited physical activity, which slows our lymphatic drainage. Many of our elderly patients will also be anxious, depressed and lonely. Geriatric massage can help our patients maintain and improve their overall health, as well as regain certain physical functions that have been reduced or lost due to aging. In addition, it can relieve anxiety and depression and provide comfort and companionship to an otherwise lonely person.

DESCRIPTION

Geriatric massage uses the same basic massage techniques as Swedish massage. It is, however, tailored to the specific health conditions and needs of the elderly population.

Geriatric massage has the following characteristics:

• Thoroughly review patient’s medical history.
• In most cases, client’s doctor will have to be consulted ahead of time.
• Short sessions. A geriatric massage session usually lasts between 30 to 45 minutes, as a longer session may be too much for an elderly person.
• Use of gentle hand motions. These motions are comfortable and soothing to the body. They are designed to improve blood circulation and heart function, prevent diabetic complications, relieve muscle tension, and relax the body and the mind.
• Passive stretching movement for shoulders, legs and feet are recommended to improve joint mobility and flexibility.
• Longer hands and feet massage helps relieving arthritis stiffness and preventing diabetes complications.
• Plan on helping your elderly patients with taking of their clothes, getting on and off the massage table, turning over or sitting up, and even getting dressed.
• Extra equipment might be necessary, like pillows, bolsters, blanket and     stepping stool.