Back Rub

Back Rub 

Purpose: 

• To increase circulation. 

• To stimulate muscle tone. 

• To relieve nervous tension and relax muscle spasms. 

• To relieve pain and discomfort. 

• To promote skin integrity and prevent skin breakdown. 

Equipment: 

• Moisturizing lotion. 

Procedure: 

1. Preparation: 

• Lower the head of the bed and have the resident lie on their abdomen if possible; otherwise, position them on their side. 

• Expose the entire back and wash and pat dry if necessary. 

2. Application of Lotion: 

• Pour a generous amount of lotion into the palm of your hand and rub your hands together to spread and warm the lotion. 

3. Back Rub Technique: 

• Start at the buttocks and work upward to the shoulders using a circular motion. Use one hand on each side of the spine, applying pressure with the heel of the palm and the thumb. 

• Rub the neck muscles well. 

• Use long strokes, moving from the buttocks to the shoulders. 

• Stroke from the shoulders to the upper arms and back down to the buttocks. 

4. Completion: 

• Place the resident in a position of comfort or assist with positioning as needed. 

• Replace the bedclothes, ensuring the resident is clean and comfortable. 

• Place the call light within reach. 

Notes: 

• Avoid applying pressure over bony areas with very little muscle covering. 

• Avoid rubbing the extremities of residents on bed rest due to the potential for thrombus formation. 

Compliance and Documentation: 

• Adhere to CMS guidelines and Requirements of Participation for Long-Term Care Facilities. 

• Document the procedure, including the resident’s response, in their medical record. 

• Note any observations related to skin condition, muscle tone, and overall comfort. 

• Regularly review and update techniques for providing back rubs according to the latest clinical best practices and regulatory standards. 

• Provide training to staff on proper back rub techniques to ensure resident safety and comfort. 

• Conduct regular audits to ensure compliance with this policy and address any gaps in practice or documentation. 

References: 

• Centers for Medicare & Medicaid Services (CMS). State Operations Manual (SOM), Appendix PP - Guidance to Surveyors for Long-Term Care Facilities. 

• CMS Requirements of Participation for Nursing Homes.