Hospice massage therapy touches body and spirit
Posted by Andrée Marie LaVallie, Massage Therapist
For massage therapists who care for hospice patients, the work we do is full of ongoing lessons and gifts. I’m continually reminded what a privilege it is to meet and participate in some small way in the lives of our patients — such diverse, interesting, wonderful, ordinary and extraordinary people. There is a bond that develops with physical touch through the understanding that as their massage therapist, I am there to make them feel better. They guide me to the best way to help them and I am there to listen and respond.
I’ve had the honor of working with many patients with ALS (amyotrophic lateral sclerosis). Due to the challenges that befall these patients, massage is a service that often makes good sense. When their muscles stop working as they once did, we can help stretch and massage those muscles to make them feel better for a little while. One such patient gave me delightful gifts of imagination and laughter, and lessons about an unfailing positive attitude and outlook that I will never forget.
Melissa was a few years younger than me and had been a teacher until her illness took her ability to work. She was in a motorized wheelchair and was quickly losing the remaining use of her hands when we first met. She had already lost her ability to talk, but her voice was bright and clear in the other ways she communicated.
She was very good at sharing her thoughts and imparting her beautiful way of seeing the world, despite her difficult circumstance. Considering her physical state, this was a surprise to me each of the many times I visited her. She had some nagging pain in her muscles as their use to her dissolved, and I was so grateful that our sessions helped her feel better. She would let me know the specifics of how she felt that day, and always couch the details in thoughts of love, gratitude and humor. She was amazing.
One of the standard techniques that we use in hospice massage therapy that can feel good to an ALS patient is “range of motion” stretches. We guide the person’s joint or limb into a stretch to the edge of what is comfortable for them. I do these movements with people almost every day, but I look at this exercise in a different way since my many months working with Melissa.
It started early on in our visits. I encourage patients to keep notes after each session to help inform our work going forward in any way that may improve the next session. Melissa always shared notes about what she wanted me to work on based on where she had pain or stiffness at that time.
Somewhere in the first several visits she started relating some of the work we did with range of motion to adventures I was assisting her to engage in through her lovely imagination. It started with the range of motion of her shoulders and elbows. She said we were swimming in the ocean with dolphins swimming beside us. She described how I was helping her learn her ninja warrior moves in slow motion. Another visit, she told me she imagined we were doing tai chi together in a beautiful meadow of green grass.
There was joy in how Melissa expressed herself in every visit, always greeting me with a big smile and playing a greeting on her Tobii electronic voice generator device. Even in the times when she was not feeling well at all, she would still instinctively smile, sometimes through tears, when she knew I so much wanted to make her feel better.
I looked forward to finding out what new adventure Melissa’s imagination may have us on. Even when I knew Melissa’s decline was making it more difficult for her to move as much as she once did, she would tell me she pictured us marching for good causes at a protest march or sharing a walk through the Japanese Tea Garden in Golden Gate Park.
We laughed at silly things like remembering the children’s game of “This Little Piggy” while stretching her toes or my inexplicable inability to work her motorized wheelchair efficiently. I appreciated her radiant spirit so very much.
As I’ve come to learn is not unusual for ALS patients, Melissa died before most of the people that cared for her expected. It seems odd that it feels surprising when a patient in hospice dies, but it happens frequently. Losing her beautiful smile and the bright light of her spirit was hard for the people who knew her.
She had her personal caregiver transcribe thank-you notes for several of the people who were involved in her care over the many months she was with JourneyCare. I was taken aback and so grateful to have received one of those cards. It seemed incredible that she had planned one more gift of thoughtful, gracious love. Then again, it was simply another example of her extraordinary grace.
I think of Melissa often as I work, and she continues to inspire me to do better. The lessons I learned from her inextinguishable positivity, her loving essence and her bright imagination will stay with me always.
Note: Names have been changed.