Purpose

• The back massage (back rub) can promote comfort and help relieve pain. It relaxes muscles and stimulates circulation.
• A good time to give back massages is after re-positioning. You also give them after baths and showers and with evening care. Back massages last 3 to 5 minutes.
• Observe the skin before the massage. Look for breaks in the skin, bruises, reddened areas, and other signs of skin breakdown.
• Lotion reduces friction during the massage. Warm the lotion before applying it. Do one of the following:
  • Rub some lotion between your hands.
  • Place the bottle in the bath water.
  • Hold the bottle under warm water.
• Use firm strokes. Also keep your hands in contact with the person’s skin.
• After the massage, apply lotion to the elbows, knees, and heels. This keeps the skin soft. These bony areas are at risk for skin breakdown.

Equipment

Roll cursor over items to see labels. For the purposes of clearly depicting the equipment, a barrier is not shown in this photo. When providing care, a barrier should always be placed on the surface before placing the equipment.

Bath blanket

Bath towel

Lotion

Delegation

• Follow delegation guidelines. Before giving a back massage, obtain this information from the nurse and care plan:
  • If the person can have a back massage
  • How to position the person
  • If the person has position limits
  • When to give a back massage
  • If the person needs back massages often for comfort and to relax
  • What observations to report and record
  • When to report observations
  • What patient or resident concerns to report at once

Preparation

• Observe quality-of-life measures.
• Review the information under Delegation and Safety and Comfort.
• Practice hand hygiene.
• Identify the person. Check the ID bracelet against the assignment sheet. Also call the person by name.
• Collect the equipment.
• Provide for privacy.
• Raise the bed for body mechanics. Bed rails are up if used.

Safety

• Back massages can harm persons with certain heart diseases, back injuries or surgeries, skin diseases, or lung disorders. Check with the nurse and the care plan before giving back massages.
• Do not massage reddened bony areas. Reddened areas signal skin breakdown and pressure ulcers. Massage can lead to more tissue damage.
• Wear gloves if the person’s skin is not intact or if required by agency policy. Do not massage areas where skin is not intact. Always follow Standard Precautions and the Bloodborne Pathogen Standard. Wear gloves when contact with any of the following is likely: blood, body fluids and other potentially infectious materials, mucous membranes, non-intact skin, and skin that may be contaminated (such as with feces or urine).

Comfort

• The prone position is best for a massage. The side-lying position is often used. Older and disabled persons usually find the side-lying position more comfortable.
• The back massage involves stroking down the back to the waist. Do not expose or massage over the person’s buttocks.

Follow-up Care

• Provide for comfort.
• Place the call light within reach.
• Lower the bed to its lowest position. Raise or lower bed rails. Follow the care plan.
• Return lotion to its proper place.
• Unscreen the person.
• Complete a safety check of the room.
• Follow agency policy for dirty linens.
• Practice hand hygiene.

Reporting/Recording

• Report and record your observations, including:
  • Breaks in the skin
  • Bruising
  • Reddened areas
  • Signs of skin breakdown