Episode 073: Caring for the Whole Person: Ronna Moore on Palliative Massage
Palliative care is often misunderstood. It’s frequently conflated with hospice care or perceived as solely focused on pain relief at the end of life. However, as Ronna Moore shared in a recent episode of the Folding Towels Podcast, palliative care—and the role of massage within it—extends far beyond these narrow definitions. It’s a holistic approach that considers the physical, emotional, social, and even spiritual well-being of individuals facing life-limiting illnesses.
During our conversation, Ronna, an experienced palliative care and oncology massage therapist, shared her perspectives on this profound and often misunderstood field. Her insights challenge common misconceptions and offer a glimpse into the meaningful work of caring for people in their most vulnerable moments.
Palliative Care vs. Hospice Care: Understanding the Difference
One of the first issues Ronna tackled was the confusion between palliative care and hospice care. “Palliative care is not synonymous with hospice care,” she explained. “Hospice care is a component of palliative care, but it’s specifically focused on end-of-life situations. Palliative care, on the other hand, can be introduced much earlier, even alongside curative treatment.”
This distinction is crucial because it broadens the role of massage therapists within palliative care. Ronna explained that palliative care is about “an approach to care for a person with a life-limiting illness, directed towards symptom management and quality of life.” It’s about reducing the impact of symptoms, whether physical, emotional, or spiritual, to improve the client’s overall well-being.
Dispelling Misconceptions About Palliative Care Massage
Throughout our discussion, Ronna addressed several common myths surrounding massage in palliative care. One of the most persistent is the idea that massage might harm someone in a vulnerable state. “There’s this misconception that if someone is nearing the end of life, massage could push them over the edge or be unnecessary or even luxurious,” Ronna said.
In reality, the benefits of palliative care massage are profound. Ronna shared a poignant example from her practice: “I had a client who was very unwell and simply wanted to feel like a normal person again. She told me that lying on the massage table, even just for a brief session, helped her feel human. For someone at this stage, the act of receiving gentle, thoughtful touch can be grounding and deeply reassuring.”
The Skills and Approach of a Palliative Care Massage Therapist
Being a palliative care massage therapist requires more than technical skills—it demands a deep understanding of the individual and their unique circumstances. Ronna described her approach to each session as a combination of inquiry, assessment, and connection. Before she even arrives at a client’s home, she gathers information from their medical records, examining details like prognosis, symptoms, and social context.
“It’s important to get a general drift of their circumstances,” Ronna explained. “Does the client have children? Do they have a carer living with them? What’s the mood like in the home? These details shape how I approach each session.”
In practice, palliative care massage isn’t about using a standard technique or a massage table. Ronna shared that in her twelve years of practice, she’s used a massage table only a handful of times. “We adapt to the client’s environment,” she noted. “We provide massage wherever the client is most comfortable—often in bed or a recliner—because it’s about meeting them where they are, physically and emotionally.”
Building Trust and Connection
Building trust is a cornerstone of palliative care work. Ronna emphasised the importance of creating a safe space for each client. “You’re constantly tuning into the client’s state—both physically and emotionally. The goal is to establish a sense of trust quickly because you’re entering someone’s personal world at a very vulnerable time.”
For Ronna, a key part of this process is setting an intention before each visit. “I take a moment to ground myself, to focus on why I’m there. This intention-setting is not just about the client; it’s also part of my self-care routine,” she explained.
This practice aligns with what Ronna calls “creating a still point in a turning world.” It’s about offering a moment of calm in the midst of the client’s often turbulent experiences, and it’s a practice that requires deep presence and mindfulness.
The Emotional and Psychological Dimensions of Palliative Massage
During the conversation, Ronna shared some of the emotionally challenging moments she’s faced in her work. One story stood out: “In my early practice, I once agreed to a client’s request to lie face down on a massage table, thinking it would help them feel normal. It turned out to be a terrible mistake—they experienced severe pain and couldn’t get off the table. It was a moment that taught me the importance of always prioritising the client’s safety and comfort over what might seem like a ‘normal’ approach.”
This experience illustrates the delicate balance required in palliative care massage. Therapists must constantly adapt their techniques to each client’s specific needs and limitations, while maintaining an overarching focus on their emotional and psychological well-being.
Self-Care for Therapists in Palliative Care
Working in palliative care can be deeply rewarding, but it also presents significant emotional challenges. Ronna candidly spoke about the importance of self-care for therapists. “If you don’t look after yourself, you’re going to burn out,” she warned. For her, self-care includes regular mindfulness practices, annual retreats, and professional supervision. She described her approach as being like a swan: “Calm on the surface, but managing a lot underneath.”
Ronna also shared how she incorporates reflective practice into her routine. After each visit, she takes a few moments to reflect on what happened, what went well, and what could be improved. “It’s about taking the experience out of the emotional self and bringing it into the cognitive sphere, which helps me process and move forward,” she said.
Professional Development and Training
Ronna stressed the importance of continuous learning for therapists interested in palliative care. “It’s not just about massage techniques,” she said. “Therapists should seek out training in areas like trauma-informed care, mental health first aid, and compassion cultivation. These skills are essential not only for effective care but also for maintaining your own well-being.”
She also highlighted the value of professional supervision, a requirement in many health services. Supervision, she explained, isn’t about critiquing techniques but rather about sharing experiences, discussing challenges, and finding better ways to support clients.
The Growth of Palliative and Oncology Massage
Palliative and oncology massage are growing fields, driven by advances in medical treatment and an ageing population. Ronna noted that more people are surviving serious illnesses like cancer, but are left dealing with long-term impacts on their health. “There’s a big role for therapists who have training in oncology massage,” she said. “It’s not just about end-of-life care; it’s about helping people live as well as possible, even with the ongoing effects of illness and treatment.”
She added that while aged care isn’t her specific area of focus, there’s significant overlap in working with older adults who face multiple health challenges. As the population ages, the need for skilled, compassionate massage therapists in these fields will continue to grow.
Final Reflections: A Calling, Not Just a Career
For Ronna, working in palliative and oncology massage isn’t just a job—it’s a calling. “The work can be intense and emotionally charged,” she acknowledged, “but it’s also constantly rewarding. You learn so much from people who are facing life’s greatest challenges. They teach you how to live.”
This sentiment captures the essence of what it means to be a palliative care massage therapist. It’s about being present in moments of vulnerability, offering comfort and connection, and approaching each client with compassion and respect.
Where to Start: Advice for Aspiring Therapists
If you’re a massage therapist interested in exploring this field, Ronna’s advice is to start with oncology massage training. “There’s significant overlap between oncology and palliative care,” she said, “and oncology massage will give you a strong foundation.” She also recommended seeking out additional training in mental health, trauma-informed care, and other areas that support a holistic approach.
Ronna emphasised the importance of continuous reflection and professional development. “It’s essential to stay grounded and open to learning, because this work is always evolving,” she advised.
Conclusion: Embracing a Holistic Approach
In the end, Ronna’s insights remind us of the profound impact that holistic, person-centered care can have on individuals facing life-limiting illnesses. Palliative and oncology massage isn’t just about relieving pain or discomfort; it’s about creating moments of peace, connection, and dignity.
For therapists who feel drawn to this field, it’s an opportunity to make a meaningful difference in people’s lives during their most challenging moments. As Ronna put it, “It’s sacred work, and it’s an honour to be part of someone’s journey in this way.”