Communicating with clients and understanding Variables.
Three special needs clients are:
- Mental Illness - Clinical Depression, BiPolar Disorder and Schizophrenia
- People with chronic illness
- The elderly
For these three particular groups special requirements may be necessary to accommodate their massage needs.
For the mentally ill suffering from depressive illness it may be necessary to provide a kind, caring, courteous and respectful attitude to make them feel safe, appreciated and respected. It is possible that these people may have an emotional episode while receiving treatment and it will be necessary to provide them with the emotional support they may need.
In addition to the emotional and psychological aspect to providing massage to someone with a depressive illness it may be necessary to use only a select few techniques to prevent any negative effects. Techniques such as tapotement can make them feel more stressed and anxious so it may be best to leave this out. Some clients will also be on medication and depending on the type; certain massage techniques may be contraindicated such as deep tissue massage.
As far as massage is concerned for people suffering depressive illness, it can be a great asset in helping these people deal with their emotions and any physical symptoms that may have manifested themselves through their condition and is a great tool to help them distress and relax. Care must be taken to prevent the client becoming too emotionally dependent on the therapist.
A chronic illness is a condition that has persisted for a long time and quite often there is no known cure, it often causes great pain and discomfort to the individual and possibly even lowers their quality of living. This condition can result in a compromised immune system which makes clinic hygiene and a good state of own personal health a high priority. Other conditions may be the result of physical injury or trauma or possibly another disease like HIV or Parkinson's.
When dealing with a person who has a chronic illness it is necessary to treat them much in the same way as someone suffering from a depressive illness: kind, caring, courteous and respectful. Massage techniques may be restricted depending on their current physical condition, medication or just simply personal preference. In some cases it may contraindicated to perform deep tissue massage and tapotement. If massage is not contraindicated then gentle, relaxing techniques like effleurage and petrissage can be performed. The key to massaging someone with a chronic illness is to help them relax.
For the elderly, receiving a massage is a chance for them to receive gentle human contact and have a chance to communicate, especially if they live in an aged care facility.
When providing massage to an elderly client it is important to provide only what they feel comfortable with. Some clients may prefer to remain seated and fully clothed others may like to lie on a bed or massage table and be undressed down to their underwear. No matter what they choose it's important to provide them with a feeling of safety, comfort and security. Just like the depressive and chronic illnesses it is important to be kind, caring, courteous and respectful.
In some cases full body massages aren't wanted and the client is happy to simply receive a hand, foot and head massage and other cases may want more. It is important to remember when performing massage on the elderly to take great care with stroke depth as the skin tends to become thin, dry, wrinkled, prone to bruising and has the possibility of tearing. Sometimes a client is happy to simply sit and talk and not worry about massage but no matter what the choice it's important for the therapist to communicate effectively with the client.
The general points in dealing with the elderly are:
- Monitor comfort and warmth
- Support weak, contracted, painful areas
- Short Session - They tire easily
- Be flexible and adaptable
- Adjust rate, rhythm, pressure and touch
- Modify massage techniques as needed
- Do not rush them
- Take time to build trust and rapport
- Listen and show interest, allow them to talk
- Be sensitive to their emotional needs
- Adapt the massage to client and situation
- Avoid deep work and be careful around the neck and chest
- Obtain permission to massage sensitive areas
- Ask what sort of help they need and support them
- Remember you are not trying to fix things or cure them
- Ensure safety on and off the table - Clean all oil off feet.
Skills required for being an effective communicator in the massage industry
- Be respectful - Every client has different needs and requirements and it's important to make them feel comfortable and secure. The therapist needs to respect the integrity of the client.
- Be a good listener - While massage is seen to be a physical profession people don't often realise it is also a form of counselling. Sometimes a client will reveal a lot of personal information while they are on the table and it's important the therapist is respectful, listens to what they say and comfort them in the process.
- Kind, Considerate and Warm - This falls in with the previous two points and without it is impossible to provide the client the feeling of safety and security
- Happy and Energetic - By portraying these emotions it can help boost the feelings of the client if they are feeling a little run down. If the client is already happy and energetic then it can lead to a very productive session, one which the client will enjoy very much.
- Be professional - Being professional gives the client the comfort they need knowing they will be respected and all the effort will be made to ensure their comfort and satisfaction. It is also necessary when problems arise.
- Compassion and Empathy - When a client is revealing personal information, something that makes feel distraught, it helps to be compassionate and empathetic to try and meet them on the same level. If there is the same level of understanding between therapist and client then the comfort of the client will be adequately met.