House Calls

By Mary Ann Foster and Mary Kathleen Rose
[Talk About Touch]

Mary Ann Foster: A group of students who were debating the pros and cons of doing house calls asked about my experience. I told them about my on-the-job training. I had gone to massage school in the early 1980s, before there were business and ethics courses to guide us. When I arrived at my first house call, a voice called out from the bathroom: “Why don’t you change the baby’s diaper and feed the dog while I finish my bath. I’ll be out in a minute.”

Mary Kathleen Rose: Whew! I’ll bet you do things differently now. 

MAF: Indeed, I do. No diapers, dogs, or dishes! Seriously, when someone first inquires about setting up a house call, I share the conditions I require, such as the client being ready when I arrive. I base my fee on mileage and time, including setup and interruptions. 

MKR: House calls can be a good way to build a new business because many people like receiving bodywork in their home. For example, I gave massage to one couple who had a new baby. It was easier for them, and working with both of them made the travel and setup time more reasonable.

MAF: The environment is important for me. There needs to be adequate space for a massage table, and the room needs to be warm, quiet, and clean. Also, clients need to be committed to receiving a massage, ignoring the phone, and leaving family matters for later. Now, I require my house-call clients to have their own tables that they can set up before I arrive. 

MKR: Early in my massage career, I shared an office with another therapist and did house calls on the days she used the office, which allowed me more opportunities to practice. To ensure my safety, I only took clients who were referred to me by someone I knew. Also, when I arrived, I made a call within earshot of the client to let someone know where I was and when I was leaving.

MAF: Massage has become increasingly popular for social events like baby showers, birthdays, or weddings. This is a great way for therapists building a practice to meet potential clients. Most therapists charge by the hour and are available for a set length of time.

MKR: There are also many people who can benefit from therapeutic massage but are home bound, such as the elderly and those with acute or chronic illnesses. This population has been a significant part of my practice. I don’t take a massage table because most of them cannot safely get on and off a table, and are more comfortable in their own beds. For these clients, I have learned ways to adapt my own body patterning so that I can work comfortably and effectively. It is nice to let them rest in their own beds without disruption when I leave.

MAF: With special needs clients, it’s important to have clear boundaries regarding your role. Be aware that family members might ask you to provide personal care for the client, which is the job of a home health professional. With such cases, I make sure to get contact information about who is responsible for the client’s personal care (family caregiver, nursing professional, etc.) and who to call if an issue arises during the session.

MKR: Special training is important when working with the elderly or ill, not only for the safety and care of the client, but to ensure that you are knowledgeable about working around medical equipment, such as hospital beds, wheelchairs, oxygen tubing, and catheters. It is also important to get information about the client’s cognitive function, because certain people (e.g., those with memory impairment or dementia) may present communication challenges.

MAF: House calls certainly have their pros and cons. In some parts of the country, there may be local or state laws governing outcall practices. Carrying a massage table can be hard on the body. Also, I’ve found that some people have trouble relaxing in their own environment, because they’re surrounded by family stresses.

MKR: On the other hand, some people are most relaxed and comfortable receiving massage in their own homes. They also avoid the stress of traveling to and from my office. I find it interesting to work in other people’s environments. Their home says much about them, and makes it easy to establish rapport.

 Mary Ann Foster, BA, CMT, specializes in movement education for massage therapists and is the author of Somatic Patterning: How to Improve Posture and Movement and Ease Pain (Educational Movement Systems Press, 2004).

  Mary Kathleen Rose, BA, CMT, practices shiatsu and integrative massage and is a consultant for massage training in medical settings. She is the author of Comfort Touch: Massage for the Elderly and the Ill (Lippincott Williams & Wilkins, 2009).