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56 m a s s a g e & b o d y wo r k n ove m b e r/d e ce m b e r 2 0 2 3 A A s your client pool ages, it's likely you will see more clients living with diabetes. Can the hands-on work you offer this aging group of clients make a difference in their quality of life? Yes, it can. Let's look at how, when performed properly, massage can address blood circulation problems often found in the feet and legs of clients with age-related diabetes, also known as non-insulin dependent diabetes mellitus (NIDDM). Let's also examine why massage therapists should use extra caution with elderly clients during the treatment session. DETERMINE THE PROTOCOL People with diabetes often develop peripheral vascular disease (PVD), neuropathy (pain, numbness, and tingling), and undetected infections due to numbness and overall poor circulation. These disturbances often lead to pre-gangrenous conditions, which can earmark the client for eventual amputation. These same elderly clients with diabetes will, more likely than not, also present with common conditions like thinning skin, fragile bones, atrophied muscles, and brittle tendons. As a result, massage therapists should adhere to a specific protocol when administering hands-on work in these cases. As far back as 1978, Dietrich Miesler, founder of the DayBreak Geriatric Massage Institute, was successful in contributing to multiple examples of canceled amputations as a result of administering his geriatric diabetic massage sequence for feet and legs—the DayBreak NIDDM Protocol—which is still taught as a vital part of the program's core curriculum. 1 Miesler's techniques, delivered properly and with great care, have proven to routinely decrease health risks and diminish negative outcomes for older clients with diabetes. KEY POINTS • When clients with diabetes are older, they will, more than likely, present with common conditions like thinning skin, fragile bones, atrophied muscles, and brittle tendons. • Massage can lower blood pressure and blood sugar levels, so a longer session could be detrimental to a client with diabetes. Massage for Elderly Clients with Diabetes By Dawn Castiglione

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