Geriatric Massage Sequence



Massage TechniquesRhonda Nelson, Ph.D., CTRS(adapted from Daybreak Geriatric Massage Project’s Massage Sequence for Geriatrics)Establishing a RapportSit or stand at eye level to the resident. Take the resident’s hand and hold it in both of yours. Be sure to introduce yourself. Explain what you are going to be doing (at a level appropriate for the resident). Take a minute to calm your self and get in the mode of breathing deeply and moving slowly.HandsApplying the Lotion/Cream (if being used): Use gentle strokes to apply lubricant to the hand or gently stroke hand. Use your entire hand.Wrist Rotation: Interlock fingers with the resident’s, then rotate the wrist in a circular motion. Stop and apply flexion/extension movement. Rotate in opposite direction.Palm Spreading: Using both your hands, align your thumbs in the center of the palm with remaining fingers on the outside of the resident’s hand. Gently glide your thumbs across the palm several times.Finger Squeezing: Slowly take each finger and squeeze several times working from palm to finger tip (can also do finger rotation)ArmsEffleurage: Put lotion/cream in your hands and spread up the arm using long, gliding strokes. Use palmar surface of your hand, applying slightly greater pressure on the way up the arm (towards the heart) than down (away from the heart).Butterfly Squeeze: Place hands with thumbs aligned (facing resident’s shoulders) in the middle of the arm. Wrap remaining fingers around the back of the arm. Gently glide thumbs up the arm while squeezing fingers in a pumping motion.Wringing: grasp resident’s arm by placing hands with fingers facing the center of the resident’s body. Gently squeeze while moving hands forward and backward in reverse sequence. Work way up and down arm.Rolling: Place elbow on arm of chair or other sturdy surface. Place hands on opposite side of arm and move in a rolling movement from hand to elbow (if resident is not able to hold arm in place, do this movement with hand rested in lap). Continue the rolling on the upper arm, working from the shoulder to the elbow.Feather/Nerve Strokes. Following a few effleurage strokes, lightly dust the arm with featherlike strokes.Head/NeckHead Stroking: If resident permits, gently stroke the head from crown to nape of neck.Temple Pressure: Place your index and middle finger on the resident’s temples. Apply mild pressure and hold. Also do circular movement.Neck Range of Motion: Keeping fingers on the temples, or placing hands on each side of the resident’s head, ask the resident to look to the right, to the left, look up, look down, make circular motion with neck. Your hands are for support and guidance, if needed.Shoulder Pressure/Squeeze: Place both your hands on the resident’s shoulders and gently press down. Keeping your hands stationary, squeeze and release several times.Petrissage (Kneading) of Shoulders: Place both hands on one side of resident’s body. With hands in parentheses formation, knead gently. Move to other side.BackEffleurage: Make long, gliding strokes over entire surface of the back. If individual is wearing clothing, stroke down from shoulders. If skin is exposed, stroke from waist up, then make an arch formation at shoulders and descend to waist.Ringing the Doorbells: Place one thumb on each side of the spine. At select spots along the spine, press in gently (as if ringing a doorbell)Laying on of the Hands: With both hands place flat against the back, hold hands briefly in different positions and apply light pressure. Move hands around the back using the same technique.Spine Vibration: Place index finger and middle finger in inverted v formation straddling the spine. Using dominant hand, apply quick vibrating pressure to the inverted v. Stop at several locations along the spinal column.Percussion: Use fists and/or side of hands (in karate chop motion) to lightly pound around the back. Experiment with other percussion movements like fingertips (in raindrop sensation).FeetFoot Pump: Support foot at ankle with one hand. With other hand, use C formation to grasp foot. Gently flex and extend the foot.Ankle Rotation: Support ankle with one hand while rotating in circular motion with other. Reverse directions.Fist in Arch: Supporting ankle with one hand, make fist with other. Place in arch of foot and roll fist back and forth.Foot Stroking: Using both hands, gently stroke the foot from ankle to toes.Toe Squeezing: Squeeze each toe several times from the base to the tip. Also rotate the toe in its joint if you like.Gentle Knuckle Stroke: Make a fist and use middle knuckles of the hand to stroke up the foot and into the lower leg using a feather stroke.LegsEffleurage: Apply lotion using long, gliding strokes from the ankle to the knee (or on up to the thigh) using palmar surface of your hand. Apply slightly greater pressure ascending than descending.Butterfly Squeeze: Place hands with thumbs aligned (facing towards the waist) in the middle of the leg. Wrap remaining fingers around leg (or extend across the leg surface if they do not reach around). Gently glide thumbs up the leg while squeezing fingers in a pumping motionWringing: grasp resident’s leg by placing hands with fingers facing the center of the resident’s body. Gently squeeze while moving hands forward and backward in reverse sequence. Work your way up and down the leg.Rolling: Place hands on the sides of the leg. Move the leg in a rolling movement.Feather/Nerve Strokes. Following a few effleurage strokes, lightly dust the leg with feather like strokes.Termination of the Session.Again, take the resident’s hand and hold it in both of yours. Thank the resident for participating. If the resident is able to converse, speak with him/her briefly. If he/she is not able to converse, offer a few words of comfort and reassurance. Move away slowly so as not to destroy the mood of the session. ................
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