Vitality in retirement years often is challenged by health changes. Retirement communities address these concerns by offering amenities and services such as exercise rooms and medication assistance. One other service becoming more in demand to help elders maintain health and independence is massage therapy.

The Association for Gerontology reports, "The age group growing fastest in our society and in many other countries is the "very old," people aged 85 and older. By the middle of the 21st century, one in five Americans will be over 65 and there will be 15 million to 18 million persons over the age of 85." This growth trend demands that professionals acquire expertise in serving the aging, and massage is one of the services where knowledge is crucial.

The No. 1 reason people are hospitalized after the age of 65 is injury from falls. Lack of physical exercise and a sedentary lifestyle lead to deconditioning, and wear and tear on joints contributes to balance instability. Massage helps by stimulating the central nervous system and by softening tissues.

To enhance the quality of life in later years, it's vital to pay attention to the body and its changes. Active seniors want to stay active, and those who suffer from progressive diseases such as Parkinson's, amyotrophic lateral sclerosis (ALS), diabetic neuropathy, chronic obstructive pulmonary disease (COPD), and multiple sclerosis or arthritis want to preserve their strength. Massage encourages wellness despite the illness.

Communication is an integral part of massage. During a massage, increasing circulation and relaxation gives an older client a recess from pain and discomfort. Many seniors use the opportunity to seek answers to their health-related questions. As people relax, they often reminisce about their lives, and as they do, an enduring sense of self-worth is fostered. These sessions can prove valuable partly because many seniors don't receive much "touch." Because massage stimulates endorphins, most clients report feeling increased energy and an improvement in their ability to sleep.

Stress accelerates aging and decreases the effectiveness of the immune system. Research shows massage decreases levels of the stress hormone cortisol. Massage often calms those affected by Alzheimer's disease and dementia. The familiarity of touch over time is beneficial. The person might not recognize the therapist, but they will remember the touch.

A survey of Spokane retirement and long-term care facilities showed that five employ massage therapists as staff members. Some facilities contract with massage therapists to serve their residents, while others allow residents or their families to arrange for their own therapists.

Not all therapists have specific training for geriatric massage. Day-Break Geriatric Massage Institute, which is based in Indianapolis and for which I am an instructor, provide workshops to train massage therapists in proper techniques. Therapists need to know about skin and musculoskeletal changes, as well as diseases common to the elderly, in order to give massage safely and effectively both to robust seniors and the very frail elderly.

Geriatric massage isn't just a lighter massage; it is work that requires sensitivity and patience. The goal is to help alleviate symptoms with the expectation of improvement in the quality of life. Dietrick Meisler, a pioneer in promoting massage for the elderly, told students, "We are not here to add years to life but to add life to years."

One example of the rising popularity of massage therapy is the Society for Oncology Massage, which was launched in April 2008. Its focus is to connect cancer patients, their families, and their caregivers with trained massage therapists. Cancer incidence increases with advancing age, and massage often serves as a reprieve from painful cancer-related procedures.

Compassionate Touch is another massage organization created specifically to teach massage for the elderly ill or dying person. Its director, Ann Catlin, writes, "Massage therapists are not in the role of diagnosing. However, knowing the symptoms of underlying diseases and when to refer to health care practitioners is essential."

What benefit is it for a facility to encourage massage for the residents?

Massage improves marketing potential. As consumers, older adults are demanding environments offering holistic approaches that enhance their quality of life.

Massage improves patient outcomes following surgery, falls, and strokes. When Medicare no longer allows residents to continue physical therapy based on a plateau in progress, massage serves as an adjunct therapy to keep patients limber and motivated.

Massage is noninvasive and safe as a treatment modality. Trained therapists know when massage is not advisable or caution is needed. Therapists in Washington state are required to be licensed, show proof of continuing education, and carry their own malpractice insurance.

The cost to a facility is nominal. The tools of the trade are the massage therapists' own hands.

In the past decade, massage therapy has gained recognition and acceptance in mainstream health-care settings such as hospitals, clinics, elder-care facilities, and hospices. All humans need caring and compassionate touch, especially the elderly. Whether working with health-care services, caring for an aging parent, or planning for your own retirement, knowing about the benefits of massage is important.