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Geriatric Massage

Like the steady sound of waves crashing on a shore, we’ve heard the information over and over for the past several years; our senior population is growing and getting older. The baby boomers are fast approaching senior-hood.

January 18, 2010  By Sharon Puszko PhD LMT

Like the steady sound of waves crashing on a shore, we’ve heard the information over and over for the past several years; our senior population is growing and getting older. The baby boomers are fast approaching senior-hood. In 2014, which is only six years away, the youngest of the estimated 78.2 million baby boomers will turn 501

Advances in technology and medicine are changing not only life expectancy, but also the quality of life for our elders.

How will this impact massage therapists?



Our increasingly large population of seniors can provide a steady, specialized client base for therapists just beginning their careers as well as a new market for experienced therapists interested in learning a new specialty. Therapists working with the elderly need to educate themselves about what it means to be older in the 21st century. While there may be typical 20-year-olds, today there really are no typical 60- or 70-year-olds. There will be 60-year-olds who are still skydiving and 60-year-olds who are wheelchair bound. There will be a 90-year-old client asking you to “do it deeper!” while she tells you about her dance lessons last night; and a 90-year-old client with severe arthritis and dementia. Gone are the days of “the old”; we can no longer use that term to apply to everyone over 65. We now have seniors, elders, robust seniors, robust elders, etc. The 65+ have become an amalgam of personalities and activity levels that rival those of generation X.


This has created a new clientele for therapists and caregivers alike – stronger, more active, elders, as well as older elders. Therapists interested in working with this population must learn to accommodate clients who have undergone surgery, have accumulated a lifetime of injuries, can’t manoeuvre themselves onto a massage table, and who might be yearning for human touch.

Geriatric massage is not simply a lighter form of Swedish massage. It involves specialized strokes and techniques designed for aging skin and muscles. It is crucial for therapists interested in working with the elderly to learn the basics of geriatric massage before practising their craft with this diverse group of people

Recent scientific research on aging and disease has included geriatric massage as a way to help aging patients. For example, the Alzheimer’s Association recommends using massage to sooth an Alzheimer’s patient who has become irritated and aggressive2

The New England Journal of Medicine described a study aimed to decrease the onset of an episode of delerium in patients with dementia.3

A control group received standard care, and the study group received a multidisciplinary team of specialists, including massage therapists. The results of the study found that the multidisciplinary team was able to prevent more episodes of delirium than the control group. One of the successful protocols used on the study group was massage.

Clients of geriatric massage report sleeping better, a reduction in stress, relief from arthritis and chronic pain, increased recovery time from surgeries, better circulation, lower blood pressure and relief from some symptoms of Alzheimer’s disease.

In a 2004 article, researchers found changes in blood pressure, heart rate, hemoglobin values and respiratory rate in patients simply as a result of being touched by a nurse.4 Another benefit touch offers to senior clientele is its effect on memory. Repetitive touch can help the elderly, especially those with Alzheimer’s, retain some body memory, which in turn might trigger the recall of other memories.

As massage therapists, it is important not to lose sight of the power our hands can have over clients. When working with the older generation, this is all the more true. In fact, this can be one of the greatest rewards of working with older clients. We can feed the souls of our elders, who may be starved for caring, friendly touch. Touch helps us to
organize information and understand the world around us, and is essential to human happiness. Sometimes a reassuring touch is all one needs to feel better.

Leave ample time in between appointments for clients to arrive, prepare for and wrap up  from their massage and to depart. Likewise, give yourself plenty of time to get to and from appointments when travelling to clients. Offer clients help with dressing and undressing, if needed, as well as manoeuvring onto and down from the massage table.



Pay attention to nonverbal cues that your client is under duress. While one may say he/she is not in pain, or that the pressure fine, facial expression and muscle reactions can tell otherwise.

Ask clients how clothed or unclothed they prefer to be and work around their preference. Some will be shy about their bodies, and other will be completely comfortable in their own skin.

Maintain firm, but respectful, boundaries with your elder clients. When you have a busy day, be sure to remind clients at the end of the session that you really must be going. On the occasion in which you find yourself with free time, there is no harm in staying to hear one more story a client wants to tell you.

Individuals being treated for chronic conditions require weekly, or more frequent, massage.

Therapists must have flexibility in positioning aging clients. The average person may not be able to turn over on a massage table and may need help getting off and on the table, if one is used.

Older adults need reassurance that they will be treated with respect and sensitivity.


  1. Thorough intake. Ask about Doctor’s care, medications, recent surgeries. Additionally, a physician’s approval is sometimes necessary.
  2. Short sessions. A geriatric massage session usually lasts no longer than 30 minutes, as a longer session may be too much for an elderly person.
  3. The decision of using either prone or supine position is based on the intake information. For example, someone with respiratory issues should not be placed in prone position. The back can be worked in side-lying or sitting positions.
  4. No long stripping strokes. The skin thins with the aging process. Fluffing is the proper technique to use so as to not tear or bruise.
  5. Always start with the feet and all strokes should move upwards toward the heart.
  6. No stretching techniques.
  7. The massage techniques used for middle-aged clients often prove inappropriate for older adults.

Lastly, geriatric massage offers specific benefits for seniors. These benefits include:

  • Improved blood and lymph circulation
  • Faster healing
  • Pain relief
  • Restored range of motion and flexibility
  • Reduced anxiety, tension and stress
  • Relief from depression
  • Enhanced immune function.


  1. Facts for Figures, “Special Edition: Oldest Baby Boomers Turn 60!”, January 2, 2006. U.S. Census Bureau
  2. Steps to Understanding Challenging Behaviors: Responding to Persons with Alzheimer’s Disease, Alzheimer’s Association, 1998
  3. New England Journal of Medicine, March 4, 1999
  4. Zur, O. & Nordmarken, N. (2004). To Touch or Not to Touch: Rethinking the prohibition on Touch in Psychotherapy and Counseling.
  5. “U.S Interim Projection y Age, Sex, Race, and Hispanic”, U.S. Census Bureau, 2004
  6. NIA Press release, October 30, 2007
  7. “The 65 Years and Over Population”, 2000 Census Brief, October 2001
  8. National Center for Alternative and Complementary Medicine:
  9. “Household Data: Annual Averages,” U.S. Department of Labor, 2005

sharon.jpgSharon Puszko, PhD, LMT is the owner, director and educator of Day-Break Geriatric Massage Institute. Day-Break conducts more than 40 workshops a year throughout the United States and internationally. The Level 1 course introduces students to the physiology and psychology of aging and specific massage techniques for the robust to age-appropriate senior. The Level 2 Advanced course works with the primary conditions of the frail elderly. One afternoon of this class will be working with residents at a long-term care facility. Another afternoon will be at an Alzheimer’s unit. Each course offers 17 CE’s [approved by the National Certification Board for Therapeutic Massage & Bodywork (NCBTMB)].

For more information, you can contact Day-Break via the website at , by e-mail at or by phone 1-317-722-9896.

Five reasons geriatric massage is important to the future of our elderly, and to the future of massage therapists

  1. The Census Bureau projects that by 2050 there will be a 114 per cent increase in people aged 65 to 84 and a 389 per cent increase in people over the age of 845
  2. A new study by the National Institutes of Health suggests that about 5.8 million Americans age 71 and older have either dementia or Alzheimer’s disease.6
  3. Only 4.5 per cent of people living over the age of 65 were living in a nursing home in 2000. This represents an increasingly robust elderly population.7
  4. In the United States, complementary and alternative medicine (CAM) is estimated to be used by 40 per cent of people and to have increased in use by 30 per cent during the last 10 years. Many people use CAM practices to relieve symptoms associated with chronic degenerative or fatal diseases.8
  5. In 2005, 66 per cent of men aged 66 to 69 reported working full time, and 50 per cent of women in the same age group reported working full time9  The aching muscles of this elderly workforce will benefit greatly from geriatric massage.

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