The severity of the coronavirus (COVID-19) has negatively impacted many industries and many massage therapists’ ability to work.
One cohort within massage hit hardest has been the therapists who work with senior massage clients within long-term care facilities.
When the pandemic became widespread in the U.S. in March, nursing homes were in the news for the way the virus spread through them like wildfire. Residents remain particularly vulnerable to viral infection due to age and underlying conditions.
COVID-19 has resulted in 210,835 deaths in the U.S. as of Sept. 30, 2020 — with 8% of all U.S. cases and 41% of all U.S. deaths linked to nursing homes, according to a New York Times database. In 20 states, at least 50% of all COVID-19 deaths are linked to nursing homes. Those figures relate to both residents and employees of such facilities.
Given the severity of the effects of the virus in older populations, the ability for many massage therapists to provide their services to seniors living in nursing homes and other facilities has been significantly reduced; however, some in the massage field believe this is a moment to seize as an opportunity to elevate geriatric massage.
An Essential Service?
Geriatric massage is massage designed to meet the needs of the elderly population. Massage therapists in this field are trained to modify pressure, techniques, length of time, position on the table and take other considerations to manage the health of their clients. The lessons learned from massage therapists who want to return to work at these long-term health facilities has been developed through significant effort.
“This pandemic has caused extreme stress and tragedy for all populations — but for no one as much as residents of nursing homes and their families, as well as the staff and their families,” said Debra Seidman, program manager of Tender Touch For All, a nonprofit organization that provides massage at residential facilities.
Executive Director Marc Silverstein founded Tender Touch For All in 2010 after noticing the need for massage therapy at the assisted living center his mother was in. The organization is adjusting protocols to meet the needs of their clients at long-term care facilities and while they have not reopened, preparation for when they do are underway.
Although massage therapy is not considered an essential service, Seidman added, the benefits massage offers to the elderly, particularly those living in residential facilities, is truly essential to their physical and emotional health.
Additionally, said Seidman, “The deaths [COVID-19] may have indirectly contributed to, and unfortunately possibly still will, as a result of the decline in overall physical and emotional health exacerbated by the decrease in human interaction and touch, cannot be measured.”
Despite most states reopening businesses, nursing homes in many states remain closed to nonessential services like massage therapy. Facilities that are open have many new protocols in place. There are approximately 15,600 nursing homes in the U.S., comprising 1.7 million beds, according to the CDC.
AGE-u-cate Training Institute is a business that offers caregiver education programs including Compassionate Touch, a program that teaches caregivers how to offer skilled hands-on touch therapy to improve quality of life to those with dementia and reduce stress among caregivers.
“I recognize that the pandemic has struck all massage therapists,” said Ann Catlin, OTR, LMT, a training consultant at AGE-u-cate, a company focused on senior caregiver training. “Those that specialize in serving elders in nursing homes are especially affected because of the vulnerability of the medically frail.”
Changes for Geriatric Massage
Long-term care facilities have implemented changes to their protocols. The U.S. Centers for Disease Control and prevention (CDC) has developed a guide specifically for such businesses, its “Coronavirus Disease 2019 (COVID-19 ) Nursing Homes and Long-Term Care Facilities” guide (cdc.gov/coronavirus/2019-ncov/hcp/nursing-home-long-term-care.html).
One change massage therapists returning to these facilities will have to adjust to is single-use personal protective gear (PPE). This includes single-use lotions and oils, gloves, masks, face shields, aprons and scrubs. Massaging clients on a patio or outdoors and ensuring the room is well ventilated, are additional protocols some facilities have implemented. Exercising proper hand hygiene and self-quarantining in the event of possible exposure are always necessary.
Wearing single-use PPE would allow a massage therapist to treat many clients in one day; however, some elderly clients may feel uncomfortable with the extra gear, said Seidman. “If we are able to see them again, the newly required PPE will likely be off-putting to at least some of the residents, and will detract from the benefits derived from human touch and close interaction — but the power of compassionate touch will prevail.”
While the situation may seem dire at the moment, it may lend itself to changes that can benefit geriatric massage therapists in the future, like full-time employment versus contract work and an opportunity to integrate massage therapy with nursing and medical staff at these centers, said the experts interviewed for this article.
“The senior living industry is under great pressure from local and state public health departments to take action where possible to limit the number of people coming in and out of their facilities,” said Cory Scurlock, LMT, president of Massage Inc., a California-based company that specializes in geriatric massage.
If you can make the case that hiring you full time means you won’t work elsewhere, your request is likely to be considered, she said.
“To advocate for your continued position in a nursing home, one must now legitimize their practice through the eyes of the surrounding medical staff,” Scurlock said. “That might mean preparing your practice to support all medically necessary paperwork in your state, or using SOAP notes for every resident [or] perhaps even teaming up with an M.D.”
Many senior long-term health care centers include independent living, assisted living, hospice care and memory care facilities. While these centers may be some of the last businesses to reopen, it is still possible for geriatric-massage therapists to seek opportunities in 55-years-old-plus communities and adult day centers, and by offering in-home services to seniors.
Touch Eases Isolation
The more troubling effect of the pandemic is the impact isolation will have on this population. Loneliness is a risk factor for mental and physical health problems, including early death, according to a study published in Perspectives on Psychological Science. Other studies have found a correlation between social isolation and increased risk of high blood pressure, heart disease, lower immune system, anxiety and depression.
The idea of seniors living in isolation is heartbreaking to many geriatric massage therapists. “There are a lot of seniors who don’t have anyone to come visit them, their spouse is gone, their family members are gone or in another state, so they don’t have regular visitors,” said Sharon Puszko, Ph.D., LMT, owner and educator at Day-Break Geriatric Massage Institute, which provides massage therapists with geriatric massage training. “Just having a regular massage therapist visit them weekly is a wonderful emotional treatment.”
Walk-up-window visits and video calls are taking the place of personal interaction. It’s a short term solution, but nothing can replace one-on-one human interaction and touch. “When this is over with, they are going to need massages more than ever,” said Puszko.
The demand for massage at these centers when they reopen could spark interest in geriatric massage within the massage therapy field, but training is essential, particularly now with heavy precautionary protocols underway at long-term care facilities, said Scurlock.
“Nursing homes are no longer a place where you can learn as you go,” she said. “If you’re interested in becoming a geriatric massage therapist, it’s imperative you take the training that will prepare you to work on residents in this industry.”
Meeting the Moment
Studies have validated the stress- and pain-relieving effects of massage, as well as its emotional and immune-boosting effects. COVID-19 might be that big push the industry needs to demonstrate the benefits and necessity of massage within the geriatric community, sources said.
“The future of geriatric massage is bright. It’s our time, finally,” said Scurlock. “All massage therapists who love to serve seniors are about to be elevated in the geriatric care community, if we play our cards right. It’s all about meeting this moment professionally and standing strong in our craft.”
The concern surrounding nursing homes for the long term has some asking, will they close forever? But those in the industry say there’s no chance of that.
“Geriatric patients still need massage, and nursing homes aren’t going away,” Scurlock said. “So we need to meet the problems caused by coronavirus with an ability to adjust and adapt.”
About the Author:
Aiyana Fraley, LMT, is a freelance writer and health care professional with more than 18 years of experience in the massage field. She teaches yoga and offers sessions in massage, Reiki, sound healing and essential oils. Her articles for massagemag.com include “Advanced Massage Training Will Take Your Career to the Next Level — Just Ask These Massage Therapists” and “The Massage Therapist’s Guide to Assisted Stretching Techniques.”
Nursing Home Informational Resources
U.S. Centers for Disease Control and Prevention (CDC) National Center for Health StatisticsNursing Home Care – FastStats
This page includes data on nursing home trends, residents and common diseases; and information on older person’s health
Department of Health and Human Services Office of the Assistant Secretary for Health, COVID-19 Nursing Home Data
“The Nursing Home COVID-19 public file includes data reported by nursing homes to the CDC’s National Healthcare Safety Network (NHSN) system COVID-19 Long Term Care Facility Module, including Resident Impact, Facility Capacity, Staff & Personnel, and Supplies & Personal Protective Equipment, and Ventilator Capacity and Supplies Data Elements.”
The New York Times Nursing Home Cases and Deaths in Long-Term Care Facilities, by State
Facilities tracked by the Times include nursing homes, assisted-living facilities, memory care facilities, retirement and senior communities, and rehabilitation facilities.