Massage - Elderly client with possible skin condition?

[Lolla]

Hi all

I have a male client 89 yrs old. Has heart/circulation problems for which he is medicated (hypotensives, also asprin).

Legs suffer the most - is prone to ulcers on them, they are extremely swollen, are very dark red/purple in colour and the skin is flaking very badly all over the lower leg (quite chunky flakes).

He requested an Aromatherapy Leg & Foot massage a few weeks back to try to soothe the swelling and increase circulation. One leg had ulcers on which were dressed by the ulcer clinic, so just massaged the other leg.

He had a fungal infection on his toes so I explained I would have to avoid most of the foot area so did the heel upwards. Used Aqueous cream with Lavender (for the dry skin) and s.marjoram (for poor circulation).

Started with light effleaurage but he said he couldnt really feel it so increased pressure with kneading, thumb walking etc.

I was concerned about the amount of skin that was coming off - I had couch roll down but did boil wash my towels several times too. However did find it hard to get the skin out from under my nails afterwards - I know now I should have worn gloves but I didn't have any and am not phased by things like this. I have gloves now though so will wear them next time.

He is booked in again in a couple of weeks for the same and if his ulcers have cleared on the other leg will be doing both.

I have concerns about A. whether I should be treating him at all? B. why is the skin flaking so much as I have little experience with elderly clients? C. Should I be using essential oils at all? D. am worried about wearing gloves during a massage as it's about therapeutic touch as well.

I have a feeling people are going to say 'Don't touch' but I've already done one treatment (inc. consultation) and everything went fine and he enjoyed it. Any advice would be much appreciated. xx

 

[Melk]

Personally I wouldn't have massaged him at that time. Only massaging one limb puts people of balance and with his Health conditions I would have explained that the where contraindications. Once ulcers healed and fungal infection dealt with it would be fine. I wouldn't have used essential oils, I use a beeswax based massage balm which is highly moisturizing or jojoba as it closest to skins natural oils. I also would have asked for a drs approval prior to accepting someone with these conditions and age. You can never be too careful and sometimes it's better to refer to someone more qualified, sounds like odema massage or lymphatic drainage would have been his best option for fluid retention.

 

[celtica]

What was the cause of the ulcers, is it down to diabetes? If so then he should not be receiving massage. Also it could be Lymphedema and should only have light massage, he really should see a experienced MLD therapist. He should also have his Doctors consent.

 

[Lolla]

Drs consent...thought so. Im kinda kicking myself for doing it coz I know it's not good doing one limb etc. But his wife is one of my regulars and she's a retired nurse so said it was ok etc, and I was there, he was on the couch and I just didn't want to disappoint him - I know that's not the correct way to do things but when you're in that situation....

Im going to call him to explain I can't do treatment without GP consent and that both legs need to be ulcer clear etc.

Thanks guys

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[Lolla]

He's not diabetic no. He said it was just swelling due to the poor circulation. So is it fluid that is making it swell? Any ideas on the flaking skin?

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