Alzheimer's & Brain Tumor

[loriel]

I had a lady contact me the other day seeking massage for the elderly woman she cares for (I assume she is a home health nurse). The woman is 86, and has alzheimer's as well as an inoperable tumor on her brain, and is in pain all of the time. The lady told me that the elderly woman's daughter had read something about massage helping people affected by alzheimer's, and wanted the nurse to contact me about it. I consulted with another MT before deciding to book an appt. for her, and she told me it would be fine as long as I use light touch, etc. I have the lady coming in on Wednesday & her daughter is supposed to be in touch with me before then so I can maybe get some more info from her.
People from that generation tend to not be comfortable being undressed in front of a stranger, and with her having alzheimer's, it may be very scary/confusing for her.

So my question is this- What would be most beneficial to this client? What areas should I stay away from? If she is uncomfortable with undressing, how should I go about a treatment?
TIA!

 

[Don T]

Definitely get as much info from her daughter as you can ahead of time. Find out how she gets around - does she walk alone, with a walker, or is she in a wheelchair? Will she be able to get on the table? With or without help? (I would be very inclined to not leave the room and have her get herself on the table.) How advanced is the Alzheimers? Will she be able to tell you what she likes and dislikes? Does the daughter suggest that you have her undress, or does she suggest leaving her fully dressed? Is she easily frightened or agitated? What calms/comforts her? Does she get cold easily, or overly warm? How is her hearing?

With my very elderly clients, I do not leave the room for them to get onto the table. If they are undressing, I stand opposite the table from them and hold a sheet up to give them some privacy, and cover them quickly as they position themselves on the table. My clients with fairly advanced alzheimers do not undress, and I explain to them *each time* how to get on the table in simple terms, and gently guide them and help them position. The massage is gentle but firm, consisting of compressions, petrissage (yes, it is quite doable through clothing), stretches, rocking, and range of motion. I watch them carefully to see if there is any agitation, and if so, move back to doing what calms them.

Some can only take 5 minutes of massage, but that 5 minutes of massage quiets them down. I once had a lady who was roaming the nursing home trying to find a way out, begging everyone she saw to take her home. She would be taken to her room and immediately come back out and start over. I asked if I could rub her shoulders, and she said yes, so I took her hand and led her to a chair and stood behind it and just massaged her shoulders for about 5 minutes. She then sat for over an hour, calmly watching me massage several others and listening to the conversation. I was told later that she STAYED calm all day. Just 5 minutes had a profound effect. It is really cool when that happens. Others can manage a whole 30 minutes on the table and deeply enjoy it. I have one who does quite well with a full hour massage, though I sometimes spend the entire hour having the same 4 line conversation over and over and over. He *cannot* remember having had that conversation 2 minutes ago. I have had some who would spend the time (2 were half hour clients, the other had an hour massage every week) telling me stories about their earlier years, and at times the stories were clearly connected to which area of her body I was massaging. (Her wedding ring having to be cut off came up when I massaged her left hand, for instance.) These ladies did not have the ability to speak coherently, but somehow the massage reconnected something and they were able to tell whole stories for awhile. One of my ladies with alzheimers sings to me!!

Some will have an incredible fear of strangers and strange surroundings - if they are taking her to your office, I'd assume this lady is not one with those fears. Some will become very upset at the mention of removing their clothes, and others will seem that they can't WAIT to strip - and you won't escape the room before they do! I had one sweet lady who had taken a shower while waiting for me (in an assisted living home) and met me in the hall on the way back to her room. As we walked, she pulled on the front of her bathrobe and giggled to me, "I'm naked in here!!" :

There isn't a "stay away from this area" with folks with alzheimers. The caution is more to pay very, very close attention to them at all times. Watch how they are responding to you and to the massage, and realize they may not connect you with the massage - or remember what you just got done telling them. Some are angry, some even violent, some frightened, some *just* confused, some quite happily living .....in another era. There are many different degrees of alzheimers and each person reacts to it differently.

You may be more comfortable if the nurse or whoever accompanies her to your office stays in the massage room with you, at least the first time or two, so that you can learn how best to interact with this particular person. Your client may also be more comfortable with someone that she recognizes being in the room with her.

 

[Love Always]

I cannot thank you enough for sharing that with me! I will wrote those questions down & ask the daughter and the nurse. I may get two different answers from each of them, but I think the nurse may be able to tell me more than the daughter. The nurse will be coming along for the appointment. I haven't had much experience with people who have Alzheimer's, so I've been reading up on it to try to get some kind of idea about what I can expect.

 

[Mr. P]

Seems I struck a nerve. I am so very sorry.

Thanks for the clarification, which was why I asked. I wasn't for sure, and thought maybe you would be in a setting where you would need some brainstorming on other ways to handle such a situation.

I probably should have asked different. But, I was so tickled about RoS's response about many older clients just jumping out of their clothes before you can reach the door. At first it shocked me... now I just try to go with the flow. I was only trying to relay my experience.

In my experience, I have had many elderly people say that the main reason they don't want to get a massage is that they would be undressed in front of a stranger. Maybe older people are different where you live.

Sometimes this can be counteracted by an in depth explanation of how teh client will be draped during the massage. I am sure you ahve done that, but I think there may be a thread or two around the forums somewhere covering some good verbalizations or website content on that, if you would like for me to look it up for you.

 

[feelingless]

pueppi- I'm sorry, I misread your post and thought that you were laughing at *me* lol, sorry. No harm done

The woman's daughter called me today, so I was able to get a little more information from her. She told me that her mother remembers relatives & people she has known throughout most of her life, but her short term memory is gone. So at every appointment, I will need to introduce myself & explain everything over again. (I expected that, not a problem.) She also said that in addition to a brain tumor, she has degenerative disc disease, and her low back & shoulders ache all the time. Also, she can't hear very well.

The daughter told me that her mother has gotten a massage before & loved it, although she has no recollection of it. She says that she *should* be fine with undressing from the waist up if assisted by the nurse (who is coming with her to the appt.) and she feels that a 1/2 hour massage focusing on her back/neck/arms/hands would be best. I was thinking the same thing. She wants to start off with this first appt & see how her mother responds to it, and if she enjoys is, she would like her to come atleast once a week, preferably twice. She also asked if I would be open to coming to her home for appts in the future when it gets harder for the nurse to get her out & about, and I said that would be fine.

One thing the daughter asked that I'm unsure of- she wanted to know if I could use hot stones on her. I can't find anything online or in my books, what do you guys think?

 

[Medori]

I don't see any reason hot stones would be medically contraindicated, but I would be a bit nervous about doing that due to the Alzheimers *and* due to advanced age causing skin to thin and be much more reactive to pretty much everything. It's an "expect the unexpected" disease, so I'd be worried about her being frightened by the temperature difference, or the weight .......or for some reason moving so fast she'd cause me to drop one on her! :shocked: So I guess if you do that, introduce them verbally before introducing one physically, check in after each stone was placed, and hang on tight to the one in your hand! I wouldn't have them as hot as usual, either - just warm stones rather than hot stones.

 

[Dr. Tabas]

Another thought - I like my hands to be free, with my Alzheimer clients, especially if they are on the table. I want to be ready and able to catch them if they start to roll off - sometimes they just decide to get up without giving any notice, and they do not remember where, exactly, they are, or how narrow the table is or anything. I honestly wish they made side rails for the table, some days!

 

[Big PAPA]

Thank you Sharon. I am afraid to use the stones because I know that advanced age causes the skin to become thinner, and what feels warm to me might be scalding hot to her. I just don't think the stones are a good idea.