Each year, millions of terminally ill patients spend many of their last days oftentimes surrounded by medical teams.
Poked, prodded. Examined and questioned.
In such a fragile time, gentle touch can show the dying they are loved.
The Heart Touch Project, based out of Santa Monica, California, offers free therapeutic touch to medically fragile and terminally ill people. Patients of all ages—both homebound and in medical facilities—benefit from compassionate touch.
From Pain to Peace
In 2015 alone, 1.38 million people received hospice care after a terminal diagnosis. Integrative therapies are making more of an appearance in such settings, and as the trend continues, so does the indication that healing touch provides pain relief in palliative care.
Studies have indicated massage in palliative care settings often reduces depression, anxiety and pain. (See “The Use of Massage Therapy for Reducing Pain, Anxiety, and Depression in Oncological Palliative Care Patients: A Narrative Review of the Literature,” for example.)
A simple laying of hands instead of a needle prick is often welcomed. Experienced Heart Touch Project volunteers witness this all the time.
“I’ve seen people go from being curled up in pain to peacefully drifting off to sleep,” said Christine Knapp, CMT, a Los Angeles-based massage therapist and longtime Heart Touch Project volunteer. “Some people’s tremors reduce, some people go from upset to calm.”
Volunteers are trained to pick up nonverbal cues, which can be useful to patients too weak to speak.
“Some people will tell me to leave, but sometimes I’m the only person that they can tell [nonverbally] to leave, so that’s still helpful to them,” said Knapp.
“The massage is one of the few times in their day that they have total control over who is touching them, and the only reason for that touch is to make them feel better,” she added. “That empowerment can be a huge relief to someone who may not have nearly as much control over their situation as they’d like.”
Knapp tries to always meet patients where they are at physically and emotionally. She’s worked on clients in their favorite chair or bed. If they’re able, sometimes she’ll work on them atop a massage table.
“Because each person’s situation is unique, you meet them wherever they’re able to relax the most,” she explained.
Earn a Specialty Certificate
In Oct. 2017, Heart Touch teamed up with the National Certification Board for Therapeutic Massage & Bodywork (NCBTMB) to offer massage therapists a new curriculum to help those dealing with chronic, debilitating pain.
After 200 hours of training and a passing score on the NCBTMB exam, therapists can receive a Specialty Certificate in Pain and Palliative Care. The certificate allows therapists to service those in hospital and hospice settings.
“NCBTMB and The Heart Touch Project’s Specialty Certificate Program in Pain and Palliative Care was created to ensure massage therapists have the knowledge and skills to enter the medical profession with confidence,” said Donna Sarvello, LMT, BCTMB, vice president of educational support for NCBTMB.
“Therapists who voluntarily take and pass the educational and examination component of this program demonstrate to key stakeholders, such as employers, that they have earned additional education and experience working with fellow medical professionals, pediatric patients, and oncology patients,” she said.
“Such an education empowers therapists to assess and utilize appropriate techniques that may help to alleviate pain without the use of opioids and pain medications.”
Because the Heart Touch Method touches so many lives, the organization’s founder felt more could be done. After a 15-year partnership with local hospitals in southern California, it became evident a need for non-pharmacological treatment needed to surface.
Pain Relief in Palliative Care
The program grew roots back in the early 1990s. Founder Shawnee Isaac Smith had a friend with AIDS who requested bodywork from her. Little was known about the disease then, and many massage therapists—and health care workers in general—were reluctant to touch AIDS patients.
After giving her friend massage, Smith realized the impact it could have on both therapist and client. Other AIDS patients began calling her, and after enough interest accumulated, she founded the nonprofit to teach others gentle touch.
The Heart Touch Project was born in 1994, and since its founding, more than 23,000 free massages have been given. A hospital ward in California was also named in Smith’s friend’s honor.
This was not a small feat for a nonprofit.
The daily impact it has on volunteers has been huge too.
“The Heart Touch Project has made me a better massage therapist, and a better person,” said Knapp. “The program helps you connect with mortality in an uplifting way, which sounds like a strange word to use when dealing with death, but it’s true.
Touch is simple, but it’s so intensely important, especially when dealing with the distress and anxiety of the end of life.”
While massage therapists certainly benefit from training in the Heart Touch Method, it’s for anyone interested in developing a loving presence to the terminally ill, especially family members.
The two-day training offers demonstrations, lectures, group sharing, experiential exercises and more to help participants — chaplains, caregivers, family members, etc. — discover appropriate tools for caring touch during difficult times.
Once training is completed, volunteers can provide free weekly massages to patients in partner hospices or hospitals through the Heart Touch Project.
A certificate of completion, HIPAA certification, free TB screening test and background check are all offered at the end of training.
No prior massage or medical experience is required for the program, but most of the partnerships require 150 hours under a certified massage school, medical license or other medical credentials to volunteer for liability reasons.
Volunteers have flown in from out-of-state since training is only held four times a year at The Heart Touch Training Room in Santa Monica. The course cost is $400 due with application, but partial scholarships are also available.
While integrative medicine is growing, there’s still plenty of work to be done.
“There’s a need to learn more about touch,” said Camille Harris, L.AC, DAOM, director of programs at Heart Touch Project. “We teach [volunteers] basic touch skills. Some hospices require they be massage therapists, and some don’t.”
Chaplains, she said, often tell her they know how to speak to patients, but touch can be awkward because they were never professionally trained in touch.
“It’s an up-and-coming field,” said Harris.” There’s a need in the pain and palliative specialty for non-pharmaceutical therapies.
“Massage and acupuncture and cognitive therapy have been widely researched,” she added. “Our main goal is to be an educational resource that is here to serve the community.”
VITAS Healthcare is an organization where the Heart Touch Project regularly dispatches volunteers to provide pain relief in palliative care
Sometimes volunteers meet patients in their own homes, nursing facilities or other medical facilities. (Massage therapists who are self-employed or independent contractors should possess a liability insurance policy that covers many modalities and protects them in case of client accident or injury.)
VITAS programs assists patients and families seeking hospice and palliative care.
“Because of the positive dynamic between our volunteers and patients, and the affirmative feedback we received from family members, our senior management made the decision in 2010 to enlist The Heart Touch Project on an annual basis in our San Fernando/Ventura area to train, not only our volunteers, but our staff as well,” said David Lackey, VITAS Healthcare volunteer services manager for Los Angeles/Ventura Counties program.
Since the partnership began, more than 100 nurses, chaplains, social workers and others have received training. The response in health benefits has been overwhelmingly positive, Lackey said.
“As a complementary therapy to VITAS’ hospice services, the Heart Touch Project has helped our patients report a reduction in pain levels, decrease feelings of isolation, and show an increase in their quality of life,” noted Lackey.
“Families report that the Heart Touch Project gives them relief from their own stresses and comfort to their loved ones,” said Lackey. “For our staff and volunteers, Heart Touch is a powerful way to connect with their patients and to be more mindful of the power of touch.”
An Alternative to Opioids
Volunteers and family members who utilize the Heart Touch Method notice profound and often immediate responses from massage recipients. Many patients have never received loving touch before.
This is why being trained and certified in the Heart Touch Method can create more opportunities for experience and networking, as well as the opportunity to contribute to the greater good.
“This specialty certificate comes at an opportune time for massage therapists across the country as we work together with the medical community to lessen the opioid crisis currently taking over the lives of many patients,” Sarvello said. “As such, many patients are seeking alternative treatment options that do not include opioids—such as massage therapy.
“In fact,” she added, “the Joint Commission now requires all accredited hospitals to provide non-opioid treatment options as of Jan.1, 2018, as part of the R3, which only further validates massage therapy’s role in integrative health care, as well as the importance of hiring educated and experienced massage therapists who understand the needs of patients experiencing prolonged pain.”
For more details on earning a Specialty Certificate in Pain and Palliative Care from the NCBTMB, visit ncbtmb.org.
Harris recalled her time during a training where a man broke down sobbing. Her voice cracks when she tells the story.
“I remember we had just got done with a giving and receiving an exercise of touch. We let people share what their process was. This 53-year-old gentleman stood there across from me. He said, ‘“That was the first time I had someone touch me and not want something from me.”’
While it’s always professional to ask a massage client if a pressure feels appropriate, it is even more crucial to the relationship when a client may be very ill.
“Always get their permission first instead of assuming they want it,” said Harris. “Their (health) conditions change rapidly.”
And while patients can’t change a terminal diagnosis, the attitudes they present help their daily outlook and those of the therapists.
Over the years, Knapp may only see patients a few times before they pass away. Even if her time with them is short, she can vividly recall special moments she’s shared, like the time she met a pancreatic cancer patient who’d never had a massage.
“He told me he was sorry he’d waited so long to have one,” she said. “His warmth and humor were present even while he was in. Later, his wife told me that she felt like my massage had helped him practice letting go, and that made his eventual transition easier.
“A few years after he passed, his wife went on to take the Heart Touch Project training and became a volunteer herself,” she added.
Hearing about moments like that are what keep professionals like Knapp volunteering for nearly a decade.
“There’s a rawness in grief that can either bring people together or drive them apart, and if I can help reduce that pain so that people have more space to come together, my time is well spent,” she said. “And to do that with something as simple as gentle touch is a beautiful thing.”
About the Author
Seraine Page is an award-winning journalist based out of Southwest Florida. She enjoys writing about health, wellness and travel. Her work has been published in Discover Kitsap, AAA Journey Magazine, DAYSPA Magazine, SANDBOXX, and others. She has written many articles for massagemag.com, including “A Whole-Family Model of Massage” and “This is How to Get a Job Working on Olympic Athletes.”
If you enjoyed reading this MASSAGE Magazine online article, subscribe to the monthly print magazine for more articles about massage news, techniques, self-care, research, business and more, delivered monthly. Subscribe to our e-newsletter for additional unique content, including product announcements and special offers.