Massage Therapy for Care of Massage Therapy for Care of People Dealing with People Dealing with

Parkinson’s Parkinson’s and and

Caregiving Caregiving

Peggy Pilkenton RN, MSN, LMT

July 30, 2011

Inner  Peace

If you can start the day without caffeine,

If you  can always be cheerful, ignoring aches and pains,

If you can resist complaining and  boring people with your troubles,

If you can eat the same food every  day  and be grateful for it, 

If you can understand when your loved  ones are too busy to give you any time,

If you can take criticism and  blame without resentment,

If you can conquer tension  without  medical help,

If you can relax without alcohol, 

If  you can sleep without the aid of  drugs,   

Then  You Are  Probably  .........              

The  Family Dog!

Parkinson’s Parkinson’s DiseaseDisease

Nerve cells in substantia nigra area of brain die off

These cells produce neurotransmitter Dopamine

Dopamine sends messages to area of brain used to control movement

Decreased dopamine results in noticeable tremor and muscle rigidity

80 % or more of Dopamine transmitting cells have been lost before symptoms show up

Common Effects of Parkinson’s Common Effects of Parkinson’s DiseaseDisease

Tremors

Slow movements

Muscle stiffness and rigidity

Pain

Fatigue

Difficulty sleeping

Depression

Tremors and RigidityTremors and Rigidity

Lead to muscle exhaustion - similar to sport related muscle stress - difference is after sporting event, muscles

get long periods of rest and relaxation - muscles of Parkinson’s patient never get

rest periods therefore suffer structural changes

Available oxygen is not enough to meet needs of muscle that trembles and stays contracted

Massage TherapyMassage Therapy

Improves circulation of bloodRelaxes tight muscles Improves joint mobility

Relieves stiffnessTriggers relaxation response

Reduces anxietyImproves sleep

Increases feelings of well being

FIVE minutes of FIVE minutes of Swedish Swedish MassageMassage

Carries 10 times the amount of blood to a massaged muscle as what would naturally occur with a 15 minute resting of the muscle

Gentle MassageGentle Massage

Releases neurotransmitters

including dopamine and production of

endorphins creating a calming effect

Enhances utilization of various L-Dopa

medication combinations

Gentle Range of Motion and Gentle Range of Motion and Stretching with Massage Stretching with Massage

TherapyTherapy

May alleviate pain and stiffness of joints

May improve movement, mobility, flexibility and balance

• one on one attention• companionship• reassurance• skin on skin contact• nonverbal communication• nurturing• calming• increased body awareness• grounding & redirection of energy

Emotional Benefits of Massage Emotional Benefits of Massage TherapyTherapy

Touch Research Institute and Neurology Touch Research Institute and Neurology Department Department

(University of Miami) and Duke University (University of Miami) and Duke University

Pharmacology Department - 2002Pharmacology Department - 2002Study of Adults with Parkinson’s Disease who

receivedMassage Therapy 30 minutes twice a week for

5 weeksRESULTS

• Performed better in ADLs• Reported improved sleep

• Greater ease moving around during day• Increased dopamine levels

• Decreased stress hormones in urine

CranioSacral Therapy (CST)CranioSacral Therapy (CST)Craniosacral System

Membranes and cerebrospinal fluid that surround and protect brain and spinal cord

“Cranium” = bones of skull, face, mouth“Sacrum” = tailbone area

CST is a light-touch, gentle therapy derived from CST is a light-touch, gentle therapy derived from osteopathic techniques that encourages own osteopathic techniques that encourages own natural healing mechanisms to dissipate the natural healing mechanisms to dissipate the negative effects of stress on central nervous negative effects of stress on central nervous

systemsystemClients remain fully clothed making it more Clients remain fully clothed making it more accessible for some than traditional massage accessible for some than traditional massage

therapytherapy

Reported CST Benefits with Reported CST Benefits with Parkinson’sParkinson’s

• Decreased pain• Increased relaxation• Improved comfort level• Improved balance and mobility• Increased ability to express self• Improved function• Improved sense of well-being• Decreased rigidity sufficient to allow

passive range of motion and slowing of progression of contractures

Edith G. Walsh, PhD, RNGeriatric Applications of Craniosacral Therapy: Established Allied

Health Professionals’ Use of Complementary ModailtyJanuary 2007

Caregiving

Concern for well-being of loved one

Physical and emotional stress

Tendency to put one’s own needs last

Increased potential for own health problems~ stress can cause or exacerbate 70-

90% of all medical conditions

““If you are traveling with small If you are traveling with small children or anyone who needs children or anyone who needs

assistance, put YOUR oxygen mask assistance, put YOUR oxygen mask on first, and then help those on first, and then help those

traveling with you.” traveling with you.”

THE THE

You can’t help another if you’re You can’t help another if you’re struggling to breathe yourself. You struggling to breathe yourself. You have to take care of yourself before have to take care of yourself before

you can help othersyou can help others

Massage Relieves Effects of Stress

Triggers the Relaxation Response

Relaxes tense muscles

Reduces anxiety level

Restores a calm mind and feeling of well-being

I’m Not Sure How This Works….But it is amazingly accurate!!!

The picture below has 2 identical dolphins in it. It was used in a case study on stress levels at St. Mary’s Hospital.

Look at both dolphins jumping out of the water. The dolphins are identical.

A closely monitored, scientific study revealed that in spite of the fact that they are identical, a person under stress would find differences in the two dolphins.

The more differences a person finds, the more stress that person is experiencing.

If you find more than one or two differences you may want to take a vacation.

HumorHumor

Is similar in effect on the body as progressive muscle relaxation

Is like “internal jogging” or an inside massage

causes release of endorphins

People who share humor together tend to be more productive, more cooperative and have fewer

conflicts

How to Choose a Massage Therapist

• Referral/recommendation from someone you know

• Preferably trained in medical massage or elder massage

• Licensed, credentials and certifications

• Belongs to a professional organization and is listed on that organization’s website

• Ask if they have experience working with Parkinson’s patients and an understanding of the disease process

Caring For SelfCaring For Self

BODYBODY

MINDMIND SPIRITSPIRIT

CONSIDER ADDING MASSAGE CONSIDER ADDING MASSAGE THERAPY TO YOUR SELF-CARE THERAPY TO YOUR SELF-CARE

AND THAT OF YOUR LOVED ONEAND THAT OF YOUR LOVED ONE