Strategies for Working with Senior Clients

By Rebecca Jones
[Ten for Today]

1. Consider the 10,000

Massage therapists looking to expand their client base would do well to consider working with the elderly. “Since 2011, 10,000 people have been turning 65 every day,” says Sharon Puszko, PhD, owner and director of DayBreak Geriatric Massage Institute, who has been training massage therapists to work with elderly clients for more than 20 years. “That’s a lot of business out there. In the past, seniors didn’t want to spend a lot of money on themselves, but seniors today don’t have that problem. They’re more aware of caring for themselves.”

2. Improve Balance

Massage can benefit the elderly in ways that go beyond relieving stiff muscles. Evidence suggests that welcome touch improves emotional health, and it may even help elderly clients prevent a potentially devastating fall. “There’s evidence to suggest that massage to feet and legs may improve elders’ balance,” says Ruth Werner, author of A Massage Therapist’s Guide to Pathology (Lippincott Williams & Wilkins, 2009). “It’s difficult to conclusively demonstrate that massage prevents falls, but we can demonstrate an improvement in balance.”

3. Calm Dementia

Sadly, dementia is a fact of life for a significant portion of the geriatric population, especially those living in long-term care facilities, where as many as 60–70 percent may suffer some cognitive impairment. “If you work in elder care or hospice, you will work with people with dementia,” says Ann Catlin, founder and director of the Center for Compassionate Touch in Springfield, Missouri. Some research suggests that massage can be extremely calming for people with dementia and can reduce paranoia and disorientation. “That’s if they like it,” Werner says. “If they don’t, it will just make everything worse.”

4. Know the Medications

“The interaction between massage and various kinds of medicines is criminally understudied,” Werner says. “Does massage make medication take-up faster? Does it interfere with antiseizure or pain medications? We truly have no clue.” Therapists should do a thorough intake interview to find out what medications a client is taking and why. Be attentive when people are getting on and off the massage table, and stay close by as they transition back to full speed following the massage, as some medication can cause dizziness.

5. Remember “SCRIBE”

Elderly skin is likely to be thin skin, so be cautious—long, intense strokes may not be appropriate. Mary Kathleen Rose, founder of Comfort Touch, uses the acronym SCRIBE to help therapists remember that method of massage, which is particularly appropriate for the elderly. It stands for Slow, Comforting, and Respectful. Direct pressure is applied Into the center of the part of the body being touched, with Broad, Encompassing contact. “It’s very safe,” says Rose, “and it doesn’t require the use of lotion. The person can be clothed, which is also a comfort for a lot of people, and, logistically, it’s easier for a person in a wheelchair.”

6. Consider Craniosacral

Craniosacral therapy can be a good option for elderly clients. “It’s a very gentle treatment,” says John Matthew Upledger of the Upledger Institute, which offers a class called Craniosacral Therapy for Longevity. “A lot of the elderly who are really frail can handle it a lot better. Plus, it gets the craniosacral system flowing, which enhances the immune system and helps complement the natural healing process.” Upledger says craniosacral therapy has also been shown to help reduce agitation, irritation, and stress in clients suffering from dementia.


7. Reduce Discomfort with Bolsters

Arthritis is another common ailment in older clients, and bolsters may help ease pressure on tender knees and the low back. “You might recommend them to a client for use at home,” says Kelly Metz-Matthews, spokeswoman for Earthlite Massage Tables. “Whether sitting on the couch or lying in bed, bolsters can reduce some of the discomfort the elderly might feel.” 

8. Apply Heat for Arthritic Bodies

Heat is another welcome therapy for arthritis. A product called Thermal Palms is a soft alternative to heated stones in which the heat comes from a hot oatmeal mixture placed inside a satiny wrap. “It glides smoothly over thin skin,” says Eric Brown, director of Thermal Palms. “It’s soft, so you don’t have to worry about bruising the person or going too deeply.”

9. Add Essential Oils

Aromatherapist Tim Blakley, of Aura Cacia, has a special batch of oils he likes to use on elderly skin. “Argan is great for aging skin,” he says. “Add lavender and it’s even better.” For skin tags—those harmless little skin growths common on the elderly—he recommends rose hips and helichrysum. Avoid irritating oils such as clove, oregano, and thyme. “As people get older, their skin gets more sensitive, so some may just be too harsh,” Blakley says.

10. Look Into Lift Tables

If you work with wheelchair-bound clients, consider a lift table that will go down to 20 inches. (For ambulatory clients, 24 inches is acceptable.) “Always start with the table at the lowest height before clients enter the room, and finish at the lowest height so they can get off easily,” suggests Jeff Riach, founder and CEO of Oakworks. “You might have to help clients to a seated position, so ending a session with the client supine is helpful.”

Also consider electric lift tables, which, while pricey, come with a federal tax credit for almost 50 percent of the purchase price, minus $250. “By the time you take into account the tax credit, that electric table can almost be less expensive than a high-quality portable table,” says David Fried of Custom Craftworks. 

Rebecca Jones is a tenured Massage & Bodywork freelance writer. She lives and writes in Denver, Colorado. Contact her at

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