From the MASSAGE Magazine article, “Expert Advice: Geriatric Massage,” by Sharon Puszko, in the March 2010 issue. Article summary: In the midst of these grim truths about Alzheimer’s disease, something to look forward to is the emergence of massage therapy as a technique for managing irritability and anxiety for those living with it. Massage can serve as a lifeline to a once-familiar world, while all other senses start to disappear.

by Sharon Puzsko

When I started working with clients with Alzheimer’s disease, I was unprepared for the feedback from them. I expected no reaction or even awareness of what I was doing. Instead, I often received a “Thank you,” or “That was great!” which was pleasantly surprising.

On the other hand, sometimes after weeks or months of working with a client, you may never hear him utter a word. Just like people without Alzheimer’s, clients with Alzheimer’s are each unique and different people. The lesson here is that one may have to redefine success when working with clients with Alzheimer’s disease.

Some time may pass before you notice your client give a positive response to massage, and in some cases, this may be slow to happen. Be attentive to every utterance a client speaks. If you progress from complete silence during the first week to one “thank you” during week two, that would be a sign the massage is connecting with the client.

Another change to look for is simply a decrease in agitation. If you notice over time a client is more calm, that would indicate the client is responding well to massage even if she never verbalizes her feelings.

On the other hand, if weeks or months go by, and the chemistry between you and a client just isn’t working, you have every right to discontinue treatment. Remember that what might work for one patient might not work for another one. As gerontologist Dietrich Miesler used to say, “Patience and adaptability are the foundation to working with this population.”

It is important to maintain open lines of communication with the client’s family and caretakers. They know how the client normally behaves, so they will be able to better tell you how and when she is responding to massage. For instance, they will notice a change in the client’s demeanor during the massage, or after it. You can also consider teaching them a short routine to use when you are not available.

Sharon Puszko, Ph.D., L.M.T., is the owner/director and educator of the Day-Break Geriatric Massage Institute. Since 1995, Day-Break has been a nationally approved continuing-education provider for beginning and advanced training in massage for the elderly, from robust to frail, including Alzheimer’s patients. For a list of class locations, visit