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Lifespan: Hands to Hold

By Karrie Osborn

Originally published in Massage Bodywork magazine, August/September 2004.
Copyright 2004. Associated Bodywork and Massage Professionals. All rights reserved.



Loneliness Can Find Us All
It's not that she was neglected or abandoned by her family. She hadn't been cheated out of a full life, and she wasn't bitter about the cards she'd been dealt. On the contrary, she was a happy, well-loved woman who was full of faith, even after being widowed for more than 20 years. But no amount of faith could keep this elderly woman from being struck with loneliness after sitting alone, day after day, in her new home -- a 12-by-12 room in a full-care nursing facility. She would rarely let on to her family that the isolation could be overwhelming, but visits started to end with extra-long, extra-tight hugs, and phone calls were a welcome lifeline to the world.

This woman was my grandmother, and it wasn't until she one day shared with me her joy of massage that I understood how much the comfort of touch had come to mean to her and how much it put loneliness at bay.

My grandmother is the perfect example of someone who learned a lot about touch near life's end.

She had to move into a nursing home in her early 80s when she could no longer care for herself. Her son brought as many of her worldly possessions into the room as he could, trying to create an environment of comfort for her after living most of her life in the family home my grandfather had built.

She admitted early on how many changes she'd had to make to survive in this new setting. The first, and the biggest, was the relinquishing of modesty. Having had only her husband and the occasional doctor touch her body before, she now had to accept the many hands that came to her aid on a daily basis, including the young man who helped bathe her. Still, she was initially more accepting of this act of touch than that of simple foot massage. In her mind, massage involved very personal interactions she was not ready to accept.

It took time, but eventually my grandmother began looking forward to seeing the massage volunteer who brought oils and strong hands to nurse her feet and ankles. She told me how good the massage made her feel, and while I knew that the therapy certainly helped her arthritic body, I also knew that her greatest comfort came in simply being touched by another human being.

I regret that I couldn't have been geographically closer to my grandmother to offer her my own hands for comfort, but I do take solace in knowing that she had the courage to let a stranger bring massage into her life and, with that, found the power of touch.

Walk into any nursing home today, and you'll see them: The aging lonely. They are easily recognizable. Look for the sadness on their faces, the pain in their eyes. With a television on for company, these men and women sit alone in their rooms. Their shelves are bare, their bulletin boards void of pictures, cards, or any memento denoting love from the outside. Those sad eyes may even hold a twinge of bitterness, asking, "Why am I still here with no one to love me?"

So many elders face their final years alone, in a nursing home, with few of the daily comforts they once knew so well. With friends gone or fighting their own battles against the ravages of time, and with families consumed with daily strifes, the last stages of life can often be spent in isolation -- both physically and emotionally. Even the best nursing facilities and the best staffs can be too overwhelmed with standard care needs to offer much time to their residents for conversation, laughter, or especially touch.

While massage is not a replacement for all that family and friends can do to fill the aching heart, or what a grandchild's gentle touch to the cheek can mean, when given with the compassion with which it is intended, massage can, quite simply, do miracles for the spirit.


Trying to Reclaim Our Touch Instincts
After decades of mechanization, we are now understanding (or rather remembering) the great significance human touch has on us -- from birth to death. The "new world" offerings that automation once promised in the 1950s are slowly being replaced in the new millennium with more hands-on approaches.

So now, for example, instead of outright shunning the act of breastfeeding, as was the rage 50 years ago when 96 percent of new mothers bottle-fed their infants,1 we're once again embracing the importance of putting a child to the breast not only for its nutritional benefits, but because of the importance of that early touch experience.

We're also reclaiming our instinct to nurture the ill and dying, both in an attempt to revive health and/or offer transitional compassion. Yet, we haven't embraced this population as openly with our touch as we have the young child. Something still holds us back from easily touching the elderly with their fragile, wrinkled skin.

"Touch is a natural and therapeutic way of being with the elderly. It is relaxing and healing, and at the same time pleasurable and sacred," writes Mary Ann Finch in her book Care Through Touch. Yet, she says, "Touch and its life-enhancing benefits are too frequently denied the elderly in our culture."

Is it that the elderly remind us too much of our own mortality? Ashley Montagu, author of the groundbreaking work Touching, says indeed it is our "unwillingness to face the fact of aging" that allows us to pretend it doesn't exist. He says it is this blinder mentality that is the principal reason for our inability to truly understand the needs of the elderly. "The most important and neglected of these needs is the need for tactile stimulation," he writes. "One has only to observe the responses of older people to a caress, an embrace, a handpat, or clasp, to appreciate how vitally necessary such experiences are for their well-being."2

Massage is one way to bring touch firmly back into the lives of the forgotten, the abandoned, and those who are alone in this new stage of life. Whether it be a family member, a nurse, or a trained practitioner, offering massage to this segment of society can be a key to its lasting happiness.


Touch Benefits
Just as with any other age group, massage has proven to be physically beneficial for the elderly, too. Massage has shown to improve circulation of both blood and lymph, stimulate the nervous system, soften tight muscles, and enhance function of the digestive and respiratory processes.3 Administering touch to the elderly can also increase appetites, decrease the need for pain medications, calm agitated states, promote restful sleep, and decrease post-surgical recovery.4

But beyond the physical, massage has a more emotional benefit for the elderly client -- to sweep loneliness away.

"Touch becomes increasingly important for those in extended care homes who receive few visitors from the outside world," says Dawn Nelson, author of From the Heart, Through the Hands, and founder of the Compassionate Touch program. "Though their basic needs are met, these men and women can remain starved for the nourishment that comes through one-on-one attention and skin-to-skin human contact."5

Nelson's work in a variety of care facilities has afforded her the opportunity to see many examples of this touch deprivation. "I have encountered residents in the hallways and doorways of nursing homes reaching out their arms and, quite literally, crying to be touched, longing for contact and for acknowledgement of the continued worth of their existence."6

It is with the elderly that touch can have the greatest significance, Montagu says. "It is especially in the aging that we see touching at its best, as an act of spiritual grace and a continuing human sacrament."7 Having someone take their hand, stroke their arm, or rub their feet can open the world back up to one of hope and love. Isolation can be swept away with a single stroke of the hand. "Tactile needs do not seem to change with aging," Montagu writes. "If anything, they seem to increase."8

Sharon Puszko, director of the DayBreak Geriatric Massage Program, says the act of offering touch to the elderly for emotional benefits is profound. "I think it's as important as the physical benefits," she says. "Sometimes the physical conditions are manifested because of the person's loneliness and stress of being alone." Giving that client an opportunity to interact with you can mean so much for their well-being, Puszko says.

With nurses, aides, and doctors having only minutes to offer, perhaps touch therapists are the only real visitors coming to see these elderly clients and interact with them. "And, even when they don't feel like massage, just hold their hand and talk," Puszko adds. "Let them talk about anything -- their new hairdo, what they had for breakfast, their new doctor. When they have someone really listening to them, it stimulates their happiness and well-being."

Nelson says in addition to fighting off loneliness, caring touch helps address other quality of life issues for the elderly, such as depression, feelings of isolation, lack of self-esteem, and anxiety.9 Touch sessions offer an opportunity for sensory, tactile, and mental stimulation and a context for social interaction, she says. They provide companionship, nurturing, and a certain type of "nourishment" that is sometimes lacking in nursing care.


Good News
The good news is that newly-built care facilities are starting to add wellness centers to their sites, and nursing homes are gradually finding the dollars to hire on-site massage therapists for their residents. An increasing number of younger massage therapists are looking to the geriatric field as a means of specialization and as a viable option for avoiding burnout and professional injury.

Puszko says while the majority of elderly clients she personally works with are still paying for massage out-of-pocket, more and more families are understanding there's such a thing as geriatric massage and finding ways to give it to their loved ones. "They used to think, 'I can't have anyone beating on my mother like that,' but now they understand what geriatric massage really is ... and that it's not sports massage," Puszko says. "I think they understand that Mom would much rather have a massage than another nightgown."


Remembering
For those outside the massage profession, touch is an age-old gift many forget they have. It's given freely to our children and our spouses, but we often overlook its power on our elders, especially as an emotional salve. The role of the massage therapist is to remind us of that gift and all it can offer to the world.

In her book, Untouched, Mariana Caplan sums it up nicely: "Though we cannot heal the soul-wound by an affectionate pat on the back, for those who have felt unloved all of their lives, a small act of kindness can shake their whole perspective about who they are in the world. Touch, when done with heart, is always healing -- period."10

Karrie Osborn is contributing editor to Massage Bodywork magazine.

References
1 Montagu, Ashley. Touching, New York, NY: Harper Row; 1986:71-72.
2 Ibid., 395.
3 Finch, Mary Ann. Care Through Touch, New York, NY: Continuum; 1999:16.
4 Nelson, Dawn. From the Heart, Through the Hands, Scotland: Findhorn Press; 2001:20.
5 Ibid., 42.
6 Ibid., 44.
7 Montagu, 396.
8 Ibid., 395.
9 Nelson, Dawn. From the Heart, Through the Hands, Scotland: Findhorn Press, 2001;43.
10 Caplan, Mariana. Untouched. Prescott, AZ: Hohm Press; 1998:xxiii.





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