Elderly client with osteoporis - any tips?

[Terry Z]

Hello,

I'm not really sure where to put this question, so please move it if it might be more appropriate elsewhere! I am newly qualified in IHM and have a Holistic Massage qualification aswell. I am only just starting out seeing clients, and therefore would appreciate the advice of more experienced therapists. I am seeing a client this week who is 93. She suffers from osteoporosis and has recently had an operation for carpal tunnel and is therefore bendaged on one arm to above her elbow. This is the brief outline I have recieved from her daughter. She would probably be unable to get onto a massage bed and therefore I thought that IHM would be more appropriate. She would like to receive massage to help her relax and because she enjoys it a great deal.

I feel it would be appropriate to ask for doctors consent before performing the massage due to the recent surgery, age, and osteoporosis. Should consent be given I would be grateful for any advice on how to differently approach the treatment of an elderly and infirm client, with regard to how she might sit, the kind of strokes I should use, things to watch out for, etc. But also with regard to the osteoporosis and post operative state and how differenltly I should approach the treatment because of this. I would be grateful for any advice! Thank you!

Best wishes

Kate

 

[Catherine Mahoney]

Hi Kate

I'm not sure you should ask for consent, as its unlikely to be given by any doctor as they have to protect themselves, just let the daughter ask informally, the doc will likely say its ok then.

Explain what will happen and get the client to sign an agreement to be treated.

You will have to approach with great caution as people with osteoporosis can break vertebrae just and other bones from sneezing and coughing (this happened to my poor mum). Very gentle massage will be very soothing. Very light pressure for frictions or cupping or anything like that.
Slightly firmer pressure may be ok on the skull as it is a thicker bone, but still concentrate on soothing rather than deeper stimulation.

While you are doing it tell her to let you know the minute anything is sore, or feels light headed, but say you tell everyone that, dont want to unnerve her.. You can then increase pressure a little if she feel ok.

I use a directors chair with a blanket over it and that is very comfy and the right height for me. She may also not be able to tilt her head much so the face massage may be tricky but still do it, even if you have to miss out some acupressure points.

I think I'd make it a bit shorter than usual first time too to gauge her reaction.

Hope all goes well, I'm sure she will enjoy it. Keep us posted.

Jan

 

[MsShyPianoGirl]

Jan

Thanks for the reply which was really useful. It strange the whole consent thing, because as a new therapist, just out of college, all our tutors where very firm about getting consent 'if you don't feel comfortable, get consent' so its stayed with me and when I come across anything unusual or semi serious I think CONSENT! I was also told that it covers the therapist to a point should there be a negative reaction in the client. So it scares me, when everythings new, and I don't want to cause harm to then not get consent. I would be interested to hear how you approach consent as an experienced therapist. It seems from what you say that doctors are often quite negative, which is a shame. Should I just be cautious in such cases? or like you say ask the client to get verbal consent?

I gave the lady a massage which she enjoyed a great deal, I avoided her back and the arm that had been operated on, and did ask for consent before I would go any further (i treated her before I got your email). I'm hoping I will hear from her again!

I liked the idea of the directors chair...do you have clients sitting upright to treat them in this way or leaning forward across a cushion?

Anyway thanks again for the advice and support!

Best wishes

Kate