Massage Therapy in Hospice Care and Palliative Care

Massage therapy in hospice care is getting recognized as a valuable complementary treatment for patients in a palliative care setting.

More and more organizations are hiring massage therapists to help reduce pain, anxiety and depression in patients and provide comfort and relaxation to those in the final stages of life. 

Not all hospices or palliative care facilities provide this specialized massage treatment. However, some qualified therapists volunteer, offering their services free of charge to people in need. 

Read along as we discover the role of massage therapy in hospice care and palliative care. We'll discuss the challenges therapists encounter, treatment considerations, and how it may improve patients' quality of life. 

Related Course: An Introduction to Hospice and Palliative Care

Essential characteristics of hospice and palliative care  

Before we dive into the therapist's roles and treatment options in hospice, let's kick things off by clarifying the essence of hospice and palliative care, including their background and functions. 

Though Dame Cicely Saunders first established the practice of modern hospice in the 20th century, its roots trace back to the 11th century. Since then, hospices and palliative care have become integral parts of health systems, operating from various facilities including nursing homes, community health centers, and even children’s houses. 

Hospices are dedicated to enhancing comfort and quality of life for individuals with terminal illnesses. Typically, this includes those in an advanced stage of a disease (cancer) with a prognosis of six months or less to live. It may also apply in cases when curative treatments are no longer effective or desired by the patient.  

Unlike palliative care, which provides a safe home alongside treatments, hospice solely focuses on comforting individuals as the illness progresses. In addition to physical symptoms and problems, patients undergo emotional stress and social and spiritual disruptions with their loved ones. Therefore, these organizations are not limited to medical treatments alone.  

In addition to medical professionals (doctors), physicians and nurses, other specialists such as massage therapists, counsellors, and psychologists team up to address the diverse needs of patients and their families. This collaboration ensures that individuals receive tailored care that considers their physical, emotional, and psychological well-being. 

The role of massage therapy in hospice care and palliative care 

Massage therapists bring comfort and peace to people in hospice care. They work with other healthcare professionals to ensure that every aspect of a patient's well-being is considered. Massage helps ease discomfort and emotional stress, providing relief for body, mind and spirit.  

However, it has many other benefits, such as:  

Pain reduction 

A recent study explored the effectiveness of massage therapy in reducing pain among patients receiving palliative oncological care. The study suggests massage therapy can reduce the severity of aches, pains and muscle tightness. It can also offer relief from the side effects of pharmacological treatments commonly used for cancer-related pain. This study highlights the need for further research to better understand the effectiveness of massage therapy in hospice care and palliative patients. 

Anxiety and depression reduction, emotional support 

The study of the National Library of Medicine has also found that massage therapy can ease feelings of anxiety and depression offering relief for patients experiencing mental complications during treatments. That’s because massage can induce calmness and improve mood.  

Additionally, the personal touch involved in massages can create a sense of connection, support and reduce feelings of loneliness for patients. While research on hospice care is limited, it suggests that massages focusing on gentle strokes, comfort and relaxation can boost spiritual well-being. 

Improved sleep quality 

Hospice patients often struggle with sleep. Massage therapy has proven effective in improving sleep quality by promoting relaxation and reducing discomfort. 

Enhanced quality of life 

Another recent study suggests that massage therapy, along with other complementary therapies, can improve quality of life for hospice patients. It does so by addressing physical and psychosocial symptoms such as muscle tightness, fatigue, pain, anxiety, and overall well-being.  

However, further research is needed to confirm these effects and determine the most effective ways to implement massage therapy in hospice care. 

Key differences of hospice and palliative care massage to traditional techniques 

The goal and approach of hospice and palliative care massage therapy differs from standard massage. Standard massage may focus on physical recovery through different techniques and deep tissue manipulation. Palliative care massage prioritizes slow, long-soft strokes and passive movements to promote relaxation and relieve emotional and physical distress for individuals dealing with life-threatening conditions. Massage therapists focus on improving the quality of life of the patients rather than curing ailments.  

When massaging palliative care patients, massage therapists need to consider various factors to ensure safe and effective treatment. These include: 

• Health and stage of disease 
• Medical history 
• Symptoms 
• Medication side effects 
• Physical condition: mobility, strength 
• Emotional and mental state 
• Preferences and needs of duration, pressure and techniques 

Therefore, massage therapists specializing in hospice and palliative care must effectively collaborate with the healthcare team. They must demonstrate strong communication skills and flexibility, and ensure the massage complements the treatment plan and enhances the patient's well-being. 

How to adapt massage techniques for hospice and palliative care 

When offering massage to individuals receiving hospice and palliative care, massage therapists must adjust their techniques and sessions to suit the needs, comfort and safety of these patients. For example, therapists should focus on supportive positioning and adjust the positions based on each patient's condition, comfort level and the medical equipment available.  

In some cases, conventional massage positions may not be appropriate, suitable or available. In these cases, therapists could give massages while the patient is lying on their side, sitting in a recliner or even in a hospital bed.  

To ensure the patient's comfort and relaxation throughout the session, therapists should implement the use of pillows, rolled towels or special cushions to support the patient's body and alleviate pressure points. 

The session duration should be considered, too. The duration of a massage session for hospice patients can vary depending on their energy levels and endurance. Massage therapists should be prepared to adapt the session length according to the patient's capabilities, considering symptoms such as tiredness, drowsiness, and general weakness and others that are often experienced in palliative care clients. 

Personalized pressure and touch 

The amount of pressure applied during a massage needs to be approached with caution as well. A lighter touch with longer strokes may be necessary in some cases. The therapist should ask for regular feedback and apply pressure according to the client’s comfort level.  

Effective communication is essential for massage therapists working with hospice and palliative care patients to understand their needs and align the massage with their treatment plan, contributing positively to their well-being.  

Therapists must transition from conventional massage methods to personalized and compassionate approaches, focusing on offering comfort and relaxation. This involves using gentle movements, being attentive to the patient's body language, and adapting techniques to meet their individual needs, recognizing the interconnectedness of their physical, emotional, and spiritual well-being. 

Effective strategies for massage therapists overcoming challenges 

Working as a massage therapist in hospice care and palliative care settings comes with its own set of challenges, including managing the emotions that come with the territory and taking care of oneself amidst it all. It's crucial for therapists to handle the demands of working with patients who are nearing the end of their lives and their loved ones, all while avoiding burnout or compassion fatigue.  

Training for massage therapists entering this field should encompass techniques tailored for hospice care, ethical considerations, and a deep understanding of end-of-life processes. Therapists should also receive training in communication skills, allowing them to communicate well with the care team and patients' families. This specialized training ensures that therapists can deliver respectful and empathetic care that meets the needs of hospice patients. 

Conclusion 

Massage therapy plays a crucial role in improving the quality of life for individuals receiving hospice and palliative care, offering emotional comfort and a sense of tranquility during the final stages of life.  

However, incorporating massage therapy into end-of-life care requires training and collaboration with other professionals to meet the unique needs of hospice patients. Further research and educational efforts are necessary to advance this field and ensure therapists are adequately equipped to contribute to hospice care effectively.  

Although some research showed that incorporating massage therapy into hospice care plans improves patient and family experiences, emphasizing its vital role in comprehensive end-of-life support.