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Touch and Energy Work at End of Life

All efforts to deal compassionately with people facing death must be sensitive to their physical, emotional and spiritual needs. Massage and energy work can bring relaxation, comfort and connection at a time when people are most likely to feel isolated and fearful. In addition to conventional massage, three other modalities—compassionate touch, reiki, and therapeutic touch—are increasingly being used to support people at the end of life.

Compassionate touch, which was developed by Dawn Nelson, is a modality that combines focused attention, intentional touch and sensitive massage with specialized communication skills.3 Reiki and healing touch are two energy-balancing approaches that seek to provide relaxation and comfort.4 Although little or no formal research currently exists on the effectiveness of these modalities at supporting people at the end of life, informal conversations with several clinicians working with people at end of life suggest that each of these modalities may contribute to greater relaxation, as well as physical and emotional comfort for people and their families at the end of life.

These three modalities have particular advantages in supporting people approaching death because they can be given to fully clothed recipients in varying levels of health who are in a variety of physical positions and can be taught relatively easily to caregivers.

Research on Massage at End of Life

To date, limited research is available about the use of massage at the end of life. In 2006, W. E. Lafferty et al. conducted a systematic review of the use of massage and mind-body modalities in improving the quality of life at the end of life.5 Of the 27 clinical trials reviewed, 26 showed significant improvements in a variety of symptoms such as emotional distress, nausea, comfort, anxiety and pain. The authors concluded that massage and mind-body modalities appear to offer support at the end of life. However, due to the substantial variation in methodologies used among the studies, more research is needed to assess the significance of the review findings and determine the value of these modalities for supporting people at the end of life.

Two small studies offer further insights into the potential use of massage at the end of life. In the first one, a group of researchers (A. Williams et al.) at Yale Prevention Research Center conducted a pilot randomized control trial in 2006 to assess the independent and interactive effects of Metta meditation and massage on quality of life in people with late-stage acquired immunodeficiency syndrome (AIDS).6 Fifty-eight patients were divided randomly into groups that used meditation, massage, combined meditation and massage or standard care. During the month-long intervention, the meditation group used a tape to lead themselves in meditation and the massage group were given 30-minute massages once per day for five days a week.

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