Adaptions to make when working with older clients

​​Continuing our series about working with older clients - I thought I would explain a little about how I work with my older clientele and outline some of the specific considerations a massage therapist needs to be aware of when working with the 65+ age bracket. I call these adaptations.

Massage is especially beneficial for older people as it helps to maintain mobility, flexibility and independence. It helps to keep “them connected” particularly if they live alone, or have few family members to support them.

Massage treatments should always be tailored to suit the client’s needs and the elderly have specific requirements. When working with older clients, physical condition is more relevant than their actual age. I find, older clients can be divided into three broad categories:

  1. ROBUST: those who show few outward sings of impaired health, look (and act!) younger than their actual age, are mentally sharp and physically active;  

  2. AGE APPROPRIATE: those who show some of the typical signs of ageing, but are generally well;  

  3. FRAIL: those who appear fragile, slow moving and may be in pain.

All three groups will benefit from massage but adaptations must be made. In all cases a thorough medical history must be taken during the initial consultation and medical approval sought if necessary. I always request that they bring a written list of medications they may be taking.


  • Be prepared to be patient and allow plenty of time for the session. Not so much for the actual treatment (up to 30 minutes is usually sufficient) but for time extra time it may take them to undress, get on the plinth, dress afterwards, use the bathroom etc.,  

  • Be prepared to help your client undress and dress afterwards;  

  • Be prepared to listen – this is really important. In some cases, I hear the same thing each session and often know what is coming when I hear “did I tell you about x or y” they would have told me this story many times;  

  • Be prepared to work at a lower level than normal. Lower your plinth if possible so they can get on and off more easily;  

  • Be prepared to adapt your normal techniques to slow, gentle effleurage strokes using very light pressure. Sometimes, I find that just applying the oil or lotion to combat skin dryness and then simply holding is all that is required;  

  • Be prepared to offer a slightly reduced rate, if necessary, as many may be living on reduced means. 

I should stress that these adaptations come from my personal experience working with my own clients. If you are drawn to working with older clients and your client base is ageing, I suggest that you consider attend a post-graduate course to learn, in detail, about contraindications, precautions and treatments for specific conditions. Sangoma Therapies and Training run relgular one-day certificate courses in Massage for Seniors and the Elderly Contact (086) 871 4467 or go to

Personally, I find working with my older clients extremely rewarding. Many of them are in their 70s and 80s (one celebrated her 90th birthday in April). I cannot really explain it but it just feels right and works very well for my practice. An added bonus - I find that as I get older myself, working with elderly clients is less physically demanding on my own body!

Finally, I cannot emphasise enough the importance of the power of touch for the elderly client and the hugely positive psychological effect it can have. To quote Dawn French from her book Compassionate Touch  “attentive nurturing touch can be a significant therapeutic factor in treating despondency in the ageing and/or the elderly because of its multiple psycho-social, mental, emotional and physical benefits”.

Mary - always here to help you help your clients

#elderlyclients #adaptationsforelderlymassage #Compromisedskin #Sensitiveskin #TherapeuticTouch

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