Wellness is having its day in senior living. ICAA’s State of the Wellness Industry study shows 8 out of 10 senior living executives are making wellness a priority in 2022. Among discussion of essential components to wellness, however, touch therapy is absent from the conversation.
Despite numerous studies proving the power of touch therapies on physical, mental, and emotional health—these benefits seem lost on older adults—especially Americans. Only one out of 10 over 65 had one or more massages in 2021, according to the AMTA (American Massage Therapy Association) 2022 research report—compared to a quarter of males and 21% of females representing the general population.
The Benefits
The Touch Research Institute (TRI) at the University of Miami School of Medicine has produced more than 100 studies and 350 medical-journal articles over a period of more than three decades. TRI founder Tiffany Field, PhD is a world-renowned authority on touch.
"We've found that whether we're studying pain or psychiatric problems or attention problems, autoimmune problems such as diabetes, and immune-system problems like cancer, they all benefit from massage. There’s not a single condition we’ve looked at—including cancer—that hasn’t responded positively to massage.” Massage works because it changes your whole physiology.” Field said in a interview on the podcast Outside the Room, hosted by CG Funk, Senior Vice President of Culture and Industry Relations for Massage Heights Franchising and Board of Director Member at the International SPA Association.
Physical
According to TRI’s findings, the health effects of touch come from moving the skin. When pressure receptors under the skin are stimulated, they send messages to the brain to slow the nervous system down, which decreases cortisol and increases dopamine and serotonin. The result is a chain of positive physiological changes, including decreased heart rate and blood pressure, which cause an overarching commonality of benefits, such as reducing stress, increasing immune function and relieving pain, in a variety of disorders and diseases.
Mental
Massage has been proven to lessen depression and anxiety, reduce stress, and improve sleep. It lowers cortisol levels and higher levels of dopamine, serotonin and oxytocin, known as the love hormone. In addition to being good for you, massage feels good.
Wendy Bosalavage, Chief Revenue Officer for LIVunLtd, has been a strong proponent of making touch therapies available to older adults—for the mind as much as the body. “Massage is a proven method to improve mental health—relaxes the body and the mind and allows you to practice mindfulness."
Social
Intentional touch from one human being to another fills a social void. connection. During the first quarter of 2022, Dr. Field did 168 interviews with media across the world and an hour-long BBC special on touch deprivation during Covid. As the most vulnerable to illness, the elderly population were hit the hardest. “Humans have a biological, universal need for contact with others. Without it, skin hunger, or touch starvation ensues,” said Field. “
The Barriers
There are several barriers that prevent older adults from valuing and receiving touch therapy. In the U.S., the biggest obstacle is cultural. Issues around touch as being somehow “dirty” or “bad” stigmatize the massage therapy profession.
Americans are not touchy-feely. A TRI study observed couples in cafes in France and the U.S., to see how often they touched each other. In the U.S., it was approximately once every 30 minutes. In Paris, it was 20 times every 30 minutes. “The pandemic has given the Americans a like an opportunity to even touch each other less, but we were already not touching each other,” Dr. Fields observed.
Lack of Demand
John Polatz, co-founder & CEO of PS Salon & Spa and SeniorTrade Advisory member, says senior living operators drastically overestimate how many seniors, even the younger ones, want massage therapy services. “In our experience, demand is essentially zero., only the communities serving the top one half of one percent of income demographic are adding massage. It is really limited to the upper echelons of senior living.”
Out of the more than 1300 salons PS Salon manages within senior living, less than 15 communities around the country (a little over 1%) have a robust massage therapy offering. In more than 11 years, PS Salon has provided exactly 3,789 massages out of 8.3 million total services in the history of the company (less than ½%.)
Licensing Challenges
Every state has its own laws regarding the regulation of massage. Some states prohibit massage in a residentially zoned building, for example. Other states allow massage, but only for the occupants of the building. At the most extreme, some states like Illinois require geriatric massage to be performed by a licensed healthcare worker.
“Massage therapy is challenging both from a zoning and a licensing standpoint,” says Polatz. “In some states, massage licensure is administered by the police department instead of the state board because it is considered an ‘undesirable practice,’ with reference to either human trafficking, escort services and prostitution. There can be archaic requirements like fingerprinting and background checks for operators with greater than a 10% stake in the business. For large companies like PS Salon or a large massage franchise, that is a non-starter.”
Business Justification
Polatz points out the challenges of running a massage therapy program inside senior living, including staffing and financial challenges. “Being reliant on a special skills single person and replacing that LMT if they leave is a massive obstacle to being consistent in your business. As an operator, ‘the juice is rarely worth the squeeze."
William Wesley Myers, Assistant Vice President of Wellness strategies for Mather, sees senior living overcoming business challenges by adopting a fee for service model similar to the hospitality industry. “The shift from an all-inclusive resort style model to a flat fee credit model or a spend-down model that can drive revenues is a great opportunity to monetize wellness services that would be an amenity or a loss leader.”
Best Practices
Forward-thinking senior living operators are bringing the power touch to residents in creative ways. Here are some best practices to overcome the hurdles and create lasting success.
Develop a Wellness Culture
Experts agree that massage needs to be part of a overall wellness culture. “Like any wellness program, massage won’t work in a vacuum,” says Myers. “It's about developing a wellness culture that supports residents to live as independent and engaged for as long as possible.”
Educate Residents and Staff
“Education is key to lower the level of intimidation for residents and even staff.” says Bosalavage. “Invite therapists and residents for a workshop about the benefits of massage, and how it can minimize the symptoms of many chronic conditions, including pain, fibromyalgia, stress-induced insomnia and autoimmune disorders. Talk about the barriers and reasons why they might not feel comfortable. When people are educated, they're a lot more open to things, including massage.”
Expand Touch in Salon Services
The salon is the ideal place to introduce more touch. Most State cosmetology licensure includes head, neck, and shoulder massage. Simple additions like scalp massage during hair services and hand and foot massage or reflexology during manicures and pedicures. Polatz sees a lot of men getting nail services because they don't come in for haircuts. “It’s not just physical, it’s social,” says Polatz.
Chair massage be a welcome addition to salon services. “It’s like a starter kit for massage because it's a more affordable, it’s a shorter time frame, easier setup and it’s less intimidating because guests have their clothes on,” says Bosalavage.
Plan for the Future
Mather is planning for the resident of tomorrow. The 80-year-old non for profit operates life planned communities in, Evanson, Illinois, Tucson, Arizona and a new-build underway in Tyson's Corner, Virginia opening in 2024. At the $500 million Tyson’s corner life plan community, 80% of the units are pre-sold and two-thirds of the depositors are of the baby boomer or Generation X ages.
“We're missing the mark in delivering to tomorrow's resident and planning for tomorrow's resident, who is going to Dry Bar and grabbing a green smoothie on their way to work. That is where the opportunity lies,” says Myers.
Conclusion
Despite the challenges, all signs point to touch therapy gaining respect as an essential component of wellness. AMTA research shows demand for massage in the 65+ category has remained flat over the years, whereas the 55 to 64 age group has crept up slightly, driven by the baby boomers demand for massage and all things wellness.
“We as boomers are already used to getting these types of services, so the demand is going to increase as we age. You and I are going to stop getting massage when we turn 70,” says Funk.