Issue link: https://www.massageandbodyworkdigital.com/i/943527
may be a four-hour opportunity for the student to hear about hospice care. A hospice massage practitioner may come and speak about the service, define the need for massage and the positive outcomes for dying persons, and present anecdotal information on what massaging a dying person is like. This segment may be extremely inspiring and informative about hospice, but not informative enough to guide you in the process of modifying or adapting massage for dying persons. Meeting a client at the last stage of their life is a complete field requiring adaptations to every aspect of a massage practitioner's skill base. Communication skills are also a primary component of this work. With core curriculums full to the brim with required courses, continuing education in hospice massage seems to be the answer. However it finds its way into the mainstream of massage education, it's time to have it appear as a viable educational opportunity. As the result of working in hospice massage for 35 years, and having taught hospice massage for more than 30 years, I have witnessed the full spectrum of growth of this field. The challenges that practitioners, organizations, and schools are faced with at this time are injuring the integrity of this invaluable and rapidly growing field of massage. We must remember that massage has been introduced into a mainstream medical paradigm that is unhealthy. This is a place where health-care providers are not supported and suffer from immense burnout and compassion fatigue, and where nursing assistants who facilitate the majority of care provided at the bedside, as compassionate as they are, many times have not been given the skills or the support needed to provide quality care for fragile beings. We have to do better if we are going to bring touch into the medical model. Touch is the integrative thread that weaves together the physical, psychological, and spiritual aspects of care to create the essence of comfort care. Isn't this why massage was introduced into hospice care in the first place? Wasn't it introduced to bring tenderness, connection, and respect to the bedside of the dying? These intentions first have to be exhibited within the foundation of the field itself. Otherwise, hospice massage will simply become part of the current unhealthy medical model. SOLUTIONS One of the primary principles of the hospice model is the team approach, and it will take a team approach to restore and retain the health of the hospice massage field. Each component of this team needs to be educated as to what is needed to retain the health and support the health of the hospice massage dynamic as a whole. All parts must work together. Educational Institutions There are two ways the schools can support the hospice massage field. 1. Find teachers who have been in the hospice massage field and add a one-day hospice massage class to core curriculum with resources for the students to obtain further education. In this one-day course, the school can educate the practitioner about issues requiring further study and give supportive resources for follow- up. Students need to know what they do not know. Basic hospice massage educational needs for an introductory practitioner are: • Standard precautions for hands-on care • Physical stages of dying and common behaviors and symptoms of each stage • Personal death awareness; includes belief systems and personal feelings and experiences related to death and dying • Modifications of massage techniques for a client's physical and emotional vulnerability • Practitioner body mechanics for providing a massage in a bed and a chair • Nonverbal communication skills • Knowing how to enter and exit a client's room or home • Knowing how to communicate with family, friends, and team members • Knowing how to provide a massage in a bed and a chair, including positioning a client with props Each one of these components has several levels of learning. However, just educating the practitioner as to what they're missing in this knowledge base is the first step. Meeting a client at the last stage of their life is a complete field requiring adaptations to every aspect of a massage practitioner's skill base. h o s p i c e m a s s a g e 3