Monday, April 30, 2012

Fit or Frail? Checklist for Senior Clients

When providing massage for the older adult, it is important to ascertain if your client is fit and robust or frail. This determination will help you formulate more appropriate treatment plans. Be sure to take into consideration other factors such as pre-existing conditions or medication use.

So how do you measure fitness and frailty? Rate your clients using the following checklist.
Low level of physical activity. This is the most significant risk factor of frailty in older adults and contributes to the remaining factors.
Sarcopenia. Age-related muscular atrophy.
Weakness. Evidenced by loss of grip strength
Self-reported exhaustion. The client may state that he or she is frequently tired or has persistent fatigue.
Slow walking speed. Slow walking speed in older adults is also strongly associated with increased risk of neurodegenerative and cardiovascular diseases.


0: Your client is fit and robust. In general, robust clients can receive a traditional and more vigorous massage.

1-2: Your client is prefrail. Use your judgment about pressure and length of treatment.

3-5: Your client is frail and benefits more from slower, gentler massage and shorter treatment times. 

 More information about Aging and Massage for the Elderly is found in chapter 16, Salvo SG. Mosby’s Pathology for Massage Therapists, ed 3, St Louis, 2012, Mosby (not yet published).