Touch therapists working in clinical environments (hospice, palliative care, or hospitals) may be required to provide care plans for the patients we see. Care plans let other team members know what issues are being addressed by massage therapy. They also help the agency meet compliance with government regulation. In many clinical settings, care plans are standard.
Care plans typically include a problem that is being addressed, a plan, and an outcome that the therapist hopes to achieve. The outcome should be specific and measurable, something like “client will report reduced pain” rather than “client will feel better.” Since many clients are nonverbal at the end of life, it can be helpful to have templates for measurable outcomes that don’t rely on client input.
Below are some sample care plans that are used at Faith Hospice, which can be adapted for use in other environments.
Problem: Pain
Plan – Light massage to upper and/or lower body as tolerated and appropriate.
Goal – Patient will report or exhibit signs of reduced pain with massage therapy, including slowed respiration, reduced need for PRN medication, and/or improved sleep.
Problem: Anxiety (can also be used for the problem of agitation)
Plan – Light massage to upper and/or lower body as tolerated and appropriate.
Goal – Patient will report or exhibit signs of reduced anxiety (or agitation) with massage therapy, including slowed respiration, absence of restless movement, and deeper sleep.
Problem: Dry Skin
Plan – Light massage with emollient cream to accessible areas of skin on upper and/or lower body as tolerated and appropriate.
Goal – Patient will exhibit signs of improved lubrication of the skin with massage therapy, including reduced peeling and itching.
Sometimes there isn’t really a presenting problem. The dying person’s symptoms are well controlled. They simply wish to enjoy massage! For that category, we sometimes use “general discomfort” which can be anything from feeling sore or stiff from inactivity to a vague sense of desire to be touched. Here is how we handle this category at Faith.
Problem: General Discomfort
Plan – Light massage to upper and/or lower body as tolerated and appropriate.
Goal – Patient will report or exhibit signs of enhanced comfort and relaxation with massage therapy, including slower respiration, deeper sleep, and/or reduced requests for repositioning.
It can be tempting to view care plans as “busy work.” But they are actually an opportunity to be mindful of the impact of massage on our clients and to educate others on the care team. We wish you luck and hope you’ll share the words you come up with to describe and measure the impact of your important work!
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