Congestive Heart Failure

[Liv]

I am new to volunteering with elderly and hospice massage clients. I was asked to do massage on a client with CHF and there is a doctors approval. I am not sure what type of massage to do for this client, as I have always learned that massage is contraindicated for CHF. Being there is a doctors order, what would you do to help this client? Any ideas? Thanks! :?:

 

[NO-FEAR]

You may want to discuss individual cases directly with the
doctor, first. Generally speaking many elderly clients have
rather fragile skin, and can often bruise easily - and that is without having CHF to begin with.

Certainly gentle, very light Swedish - using lotion or oil especially on hands & feet is usually appreciated by many of those who may not be recieving a great deal of touch, beyond those providing their basic medical care. Also simply recieving the moisturizing benefits will also be wonderful for them as well. Depending on your training you can do some very nurturing reflexology or energetic work with your client too. Don't forget to find out if your client has any skin sensitivities or allergies to any particular ingredients
before you have the first session too.

 

[tanmanjones]

I'd be concerned with Swedish increasing the circulation & overwhelming a heart that is already failing. Facial massage could be soothing, as could hand massage. Regarding the feet, expect them to be highly swollen, so your touch needs to be very light, and avoid pushing that fluid back toward the heart.

Bluejeans, you said that you're new to volunteering with hospice. Have you received training in massage for the medically fragile? If not, I recommend at least reading up on techniques & cautions. Here are some articles to get you started:

http://www.massagetherapy.com/articles/index.php/article_id/566
http://www.massagetherapy.com/articles/index.php/article_id/545
http://www.massagetherapy.com/articles/index.php/article_id/41

 

[Emily W]

We were taught in school that with any congestive ailment - heart failure, pulmonary edema, etc. to use techniques that were light, and generally moved fluids, etc away from the heart/lungs to avoid furthering the congestion. We were also taught to either elevate the head of the table or the client's head to aid in their breathing, etc. as being flat is not always conducive to their comfort.

In my practice, I've worked with 4 people with congestive heart failure, 2 with pulmonary edema and 1 person with both problems. Elevating the head is a definite "do it" from personal experience. Most of the work I did was mild swedish massage especially on hands, feet and legs. The rest I "played by ear" per each client's requests and we all got along fine.

fwiw

 

[luiselbatigol1981]

We were taught in school that with any congestive ailment - heart failure, pulmonary edema, etc. to use techniques that were light, and generally moved fluids, etc away from the heart/lungs to avoid furthering the congestion. We were also taught to either elevate the head of the table or the client's head to aid in their breathing, etc. as being flat is not always conducive to their comfort.

These are very good suggestions.

My mother has chf along with many other contraindications (COPD, diabetes and more) and I will massage her, I am just very cautious in what I do and I make sure I am aware of things like how she's breathing, the color, temperature and "fullness" of her tissues and I make sure I check in with her on how's she's feeling during the massage, making sure she doesn't get lightheaded, dizzy or any heaviness in her chest.

I know that it's very important to be aware of contraindications and to know how to adjust your techniques, but I honestly feel that there's some kind of massage that can be done on everyone no matter what conditions they have. You just have to know exactly what their body can tolerate and know which techniques will not be harmful to them.

Angie

 

[maskedone]

We were taught in school that with any congestive ailment - heart failure, pulmonary edema, etc. to use techniques that were light, and generally moved fluids, etc away from the heart/lungs to avoid furthering the congestion. We were also taught to either elevate the head of the table or the client's head to aid in their breathing, etc. as being flat is not always conducive to their comfort.

These are very good suggestions.

My mother has chf along with many other contraindications (COPD, diabetes and more) and I will massage her, I am just very cautious in what I do and I make sure I am aware of things like how she's breathing, the color, temperature and "fullness" of her tissues and I make sure I check in with her on how's she's feeling during the massage, making sure she doesn't get lightheaded, dizzy or any heaviness in her chest.

I know that it's very important to be aware of contraindications and to know how to adjust your techniques, but I honestly feel that there's some kind of massage that can be done on everyone no matter what conditions they have. You just have to know exactly what their body can tolerate and know which techniques will not be harmful to them.

Angie

Ditto. Having them sit in a recliner can be very helpful, and honestly I can do some sort of massage on every area of the body with the client in a recliner.

By the time someone gets to hospice, the contraindications are important to know just so that techniques can be adjusted to their comfort. There is no "don't touch" - touch is so important, and quality of life is THE goal in hospice.

 

[raethelyn]

Thanks to all. I do have hospice training but was just wondering if there was anything specific to do or avoid. So, thank you for all your answers they are all helpful. This will be my 2nd hospice massage and I guess I am just being real cautious, which is a good thing. Many thanks!