 In the beginning I came across the opportunity to work in care homes by pure luck. I lived with my family for three years in London, in a new-build residential village where nobody knew anybody: lots of busy people who were mostly expats. The concierge team was the only point of contact. In June ‘19 I moved to Kent and I faced a completely new reality. Most of my neighbors here are over 60 years old. They really wanted to get to know me and my family, and the community spirit was strong.
Three days after we moved in, we received a welcome card. Two days after that Michael (72), who lives on my street, came to say hello and invited me to volunteer in regular events at different care homes in our area. These are musical gigs for the residents. We sing all kinds of songs with them, from war songs to Christian songs. The repertoire includes Cliff Richard, Elvis Presley, The Beatles and many more completely unknown to me. My main role is to make sure the correct video comes up for each song on the TV screen. My first gig was in September ‘19 in a big residential home, managed by Bupa (a private health insurance company) with 120 residents, some of them in different stages of dementia. After the gig I went to see the Activities Manager and ask if she would be interested in organizing a Shiatsu taster session for the staff and the residents. She said yes, and this was the beginning of my journey. My experience is based on six months of work with care homes and here are my ‘lessons learned’. I hope my story will inspire some of you to introduce Shiatsu to the elderly people in the care homes near to you. Lessons learned I will divide them into three categories: • Marketing and research • Taster sessions - working with the Activities Manager • Shiatsu challenges and treatments Marketing and research I used a classical marketing approach. First, I prepared an Excel spreadsheet listing all the care homes near me. I used https://www.carehome.co.uk/ as a database. It turned out that there are 18 of them. The next step was to send an e-mail to each one and try to organize a meeting. This communication channel didn’t work. I expected a better response and was disappointed, but in Sales you keep trying until you manage to book a meeting with the key decision maker. So next I divided the list of care homes into four groups, according to location, and over four days I visited each of them with a small pack of presentation materials. My first surprise was that most of the care homes are like fortresses. The first point of contact is the receptionist. Some of them are extremely well trained to keep you away from the Care Home Manager and the Activities Manager. After the first few meetings it was clear that I would have to offer free taster sessions if I wanted the Activities Manager to present my services to her/his boss. I had to be flexible and to adjust my offer according to the needs of the particular home, the style of work of each Activities Manager, and their budget. Each care home where I managed to organize a taster session has their own politics and requirements for outside ‘vendors’. It is helpful to have proof of the Disclosure and Barring Service (DBS) check and other papers (see below for a full list). Taster sessions I offered three different types of taster session. My very first attempt was with a massage chair. It was a struggle for me and for my clients. Most of them were over 80 years old and I wasn’t aware how stiff the human body could be. The real problem is the sitting down and standing up from the massage chair. It requires the help of the staff and in some way is disrespectful to the needs of the elderly people. My oldest client, a 97year old lady, was so tiny that the design of the chair was simply not suitable for her body. Her face was at the level of the chest support and I had to use pillows to support her. After adjustments she managed to relax during the session, but unfortunately the adventure wasn’t over. It took two carers, and me holding the massage chair, to try and find the best way to help her stand up. The second type of taster session lasts about 2 hours (approximately 15 minutes per person) and includes arms, back and head treatment for any residents who are curious to try it out. The treatments are usually in a quiet room, with the resident sitting in an armchair surrounded by staff and other residents. It is not the best setting for a Shiatsu session, but the receiver does become aware of the quality of touch, and what kind of support they could receive. The third type of taster session is a 20-25 mins full body session given in the resident’s bed. This is the most comfortable way to receive, although it can sometimes be very challenging for the giver. Shiatsu Challenges and treatments The first big obstacle I faced was in gathering information about the person I was working with. There are many factors to consider, like the level of dementia and the physical state of the person. Often, members of staff gave me contradictory information about the client, because there are multiple carers looking after one person, and the client is not always aware of their own condition. The degree to which you can share personal and medical information with outside vendors is also a grey area. The usual techniques for working on a futon or in a massage chair, are not applicable when the receiver is in their bed. Rotations are not usually possible; the alignment of the spine in standing or sitting position is also harder because of the lack of space around the bed and most of time the clients are in supine position. The time frame is different too, as I usually only have about 20 minutes to work with the person. I observed that I’m using more points and Tsubos instead of working on the meridian and its extensions. I change my focus as well - to work on parts of the body, listening for Kyo/Jitsu reaction and expanding my focus to connect this part with the whole field. Some of the clients need time to accept human touch, especially from a stranger. Building trust and a sense of support and care is the main aim for the initial session. This was the case with B. (85). During the first session with the massage chair, she didn’t talk. Her body almost jumped when I started gently palming her back. She complained that it was painful when I held her arm and I continued by projecting Ki without any pressure. I used simple ‘holding’ for her shoulders and the tension finally started melting away. Our second session was completely different. This time she knew what to expect and it was a pleasure to share with her - not only 30 minutes of Shiatsu, but also her fresh sense of humor. I tried using Hara diagnosis but found that placing my hand on the belly often made my clients ‘contract’, especially if this was our first meeting. So I decided to try an ‘inner dialogue’, a technique I learned from Gabriella Poli during her workshop in London in Oct ‘19. I adapted this approach by connecting with the Ki field of the person and silently asking about the area they most needed to have touched and supported. “We are able to feel how the energetic body can expand and create a larger body of vibrations which we call the Ether body. This Ether body has the ability to expand into an even larger body called the Astral body. When we access each one of these expanding bodies, we tap into more of our potential for healing and self-realization” Gabriella Poli (link: http://www.gabriellapoli.com/multidim-shiatsu-eng.html) Based on my current experience the most successful way to work with clients who have been diagnosed with dementia is acknowledging their core being. I’ve been exploring this type of connection for a year in my Seiki practice with Alice Whieldon and in the practice classes with Adam Hellinger. “At the point of recognition, of ‘ah, I see’, is a little leap of joy in seeing and being seen. This is not-doing, not because you suddenly stop doing something in order to not-do but because there is nothing to do here.” Alice Whieldon In terms of quality of touch, most of the elderly people are very sensitive. A very light touch, without bodyweight, is enough, and they are really able to recognize the attention and presence. This also avoids the risk we need to consider when working with clients with severe osteoporosis. My presentation materials I discovered that the person to talk to in the care home is someone in the role of the Activities Manager or Activities Co-Ordinator. Usually these people have more than three roles: they are project managers, drivers, entertainers, manicurists, office workers and, during lunchtimes, I have seen them helping the rest of the staff look after the residents. When I recognized that, I decided that it would be important to make life easier for them by preparing a ready-to-use pack of documents. This includes: • A clear, easy-to-understand financial offer • My CV and copies of all certificates • The Disclosure and Barring Service (DBS) check • A short presentation about Shiatsu • A document which explains the areas where Shiatsu could support the wellbeing of the residents, along with links to articles and scientific findings. I also added links to research about the effects of therapeutic touch and dementia • Promotional materials ready to use for the residents and their families - like a poster with information about the taster session and a poster for the regular sessions. I believe that our Shiatsu work could make a real difference to the quality of life of the residents at care homes. I have never been more grateful to my teachers at Shiatsu College, especially to Annie Cryar and Jane Lyons for all the shared knowledge, patience and love, and for making it possible for me to share my Shiatsu with these people. There are plenty of specific issues we could address like anxiety, insomnia, high/low blood pressure, tactile deprivation, constipation, breathing problems, loneliness. However, what feels meaningful in the 20 or 30 minutes when I see and recognize the human being in front of me, is the heart-to-heart connection when we meet in a Shiatsu session with simple human touch. Sources: Poli, Gabriella, Shiatsu and the elderly Palmer, Bill, Working with the Elderly Beresford-Cooke, Carola, European Shiatsu Congress: Shiatsu and loneliness Articles on healing and therapeutic touch: Yuan, Susan L.K, Berssanetti, Ana A. Berssaneti, and Marques, Amelia P. Effects of Shiatsu in the Management of Fibromyalgia Synptoms: A controlled pilot study Keltner, D., Hands On Research: The science of touch, Greater Good Magazine Jones, J., Why Physical Touch Matters for your Wellbeing Greater Good Magazine Lake J. Healing Touch and Therapeutic Touch for Dementia, Psychology Today Wegerer J. How Sensory Stimulation Can Help Alzheimer’s © Snezhana Stoeva 2020 This article was published in the summer issue of the Shiatsu Society Journal, 2020 Comments are closed.
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