Massage Therapy for Clients with Dementia

Recently I was interviewed for an article in the American Massage Therapy Association journal about the benefits of providing massage therapy to clients with dementia. I think it would be beneficial to share my answers in this month’s blog.

Can massage therapy improve the quality of life for those with dementia?

Massage therapy provides a nurturing touch that conveys caring in a more powerful way than words. It can improve feelings of security and calm anxiety by invoking the relaxation response provided the client enjoys the touch and trusts the therapist. They may not remember the therapist by name or face, but they will remember how the therapist made them feel.

What are some special considerations to make when massaging someone with dementia?

I ask for permission from the client, even if a caregiver has arranged for the massage. It’s important that the client have some understanding of what I am going to do.  If a client shows hesitation or doubt, I would ask to simply massage their hands until they are comfortable with something else.  Maybe the session is just the hands or, if the client doesn’t want me to touch them at all, we just sit together, allowing them a space to be.

How do you ensure safety and avoid distress during the session?

Most importantly, I perform the massage at the client’s location with a caregiver nearby. It is important that a caregiver stay present and not leave the premises, even if the client is in the early stages of dementia.  Simply because dementia is an unpredictable condition and I don’t know the client’s situation well enough to reassure them if they become distressed.

I ascertain as well as I can the client’s preferences for music, aroma, and lighting to make them as comfortable as possible. In advanced stages of dementia, I will have to rely more heavily on caregiver input in terms of client preferences.

How might a session differ from a typical massage?

 I do not ask the client to undress because consent is tricky with a person who has dementia. I do not want them to become confused about why they are undressed, who I am, and what I am doing to them. If the client is accustomed to massage and chooses to undress, then that is their choice.

Especially at first, I am prepared to perform the massage off the massage table.  Lying down on the table puts the client in a vulnerable position that might cause the client distress unless they are accustomed to massage. I tell the client that they can tell me to stop if they don’t like what I am doing and I check in frequently.

In short, I am ready to adapt the session each time I visit.

What is the typical session duration for someone with dementia?

For a first session, I schedule a 20-minute seated session to determine if a client is open to massage.  If a client wants to continue and go further, I will suggest a 30- to 45-minute session on the table, depending on their level of awareness.  I assess the client’s openness and enjoyment level at each session, ready to pivot to a seated massage and shorter session if need be.

You can read the full article on the Massage Therapy Journal website.