10 minutes with Nicolette Powell
Relieving her uncle’s symptoms with massage in the lead-up to his death helped Nicolette Powell realise her true calling. Now an enthusiastic palliative care massage therapist, she shares some of the challenges and great rewards she has experienced along the way.
What made you focus on massage for people who are terminally ill?
I had been working as a massage therapist for about five years when my uncle was diagnosed with cancer for the second time and given 12 months to live. I started visiting him once a week to give him a massage.
We would talk for a few hours first. He was always trying to make other people feel better about his diagnosis. I felt very privileged that he would drop that with me and say what was going on in his head. He gave me incredible insight into the thoughts and feelings of a person who is dying.
I was trained in remedial massage and so I started doing deep tissue work on my uncle, just as I would anyone else. But it didn’t feel right to me and I was worried that I would hurt him. I Googled ‘cancer massage’ and I discovered that you could get oncology massage training. As soon as I saw it, I said ‘That’s what I need to do’.
The training focussed on massaging people with cancer, but fortunately the knowledge transfers to other conditions as well. I also have clients with motor neurone disease, end-stage renal failure or end-stage cardiac failure.
"I know in every cell of my body that this is my path and it just felt wrong to do anything else."
Why do you need specific training for work in palliative care?
There are dangers if we don’t know what is going on in someone’s body. I do a fairly comprehensive health history and ask about the nitty gritty of their disease to make sure that what I do makes them feel better and not worse.
You need to keep in mind things like tumour sites, blood clots, or where the integrity of a bone might be compromised. Then you can be careful to work around those areas.
The training drilled in a lot of medical knowledge. We did our final modules at the Olivia Newton John Cancer & Wellness Centre at the Austin Hospital in Melbourne. That’s when we started massaging real patients.
Palliative care massage is very different to remedial massage – it is much gentler. People are quite frail and vulnerable at the end of their life. Initially, I found backing off and being so gentle quite challenging, but now I can’t imagine working any other way. Clients are surprised by how much that gentle approach can loosen them up and how much better they feel afterwards.
What difference can massage make?
At the very least, it helps people to feel more relaxed. It’s really good for anxiety.
I’ve also seen it help with shortness of breath. It helps some people to calm their breathing and it makes it easier for them to breathe. I’ve seen it help some people with pain and nausea.
I usually ask people to rate their symptoms with a number between zero and 10 before I start and then when I finish. Usually there is a drop, so their symptoms have improved, but the extent varies from person to person.
I had someone recently who was very nauseous and feeling really flat and down. I massaged his feet while I told him one of the crazy stories from my life. By the end he had colour in his face, his mood had lifted and he said his nausea had gone. I think a large part of it was being able to distract him.
So what was your crazy story?
It’s about the time I went on Millionaire Hot Seat, which is a TV quiz show. I got onto the show because of my work.
At the time I was almost financially ruined. I had discovered palliative massage work and it was all that I wanted to do. But there aren’t many jobs out there for palliative massage therapists. I managed to get casual work, which I loved, but it was a serious struggle financially. I just stuck at it, probably way longer than I should have.
Anyway, I auditioned for the show and then I got a call to say they wanted me for hero’s week! By heroes, they meant people who had wonderful jobs in the community, as well people who had done things like running into a burning building to save someone.
There were doctors and nurses on the show, who like me, felt very uncomfortable, because none of us saw ourselves as heroes at all. We just had jobs and that was what we did for a living. It was crazy. Then I ended up winning $50,000 and I felt really guilty about that, because there was a foster mother who really could have done with the money as well.
In the end, I made my peace with winning the money because I’d made a lot of sacrifices in order to focus my career on palliative care. I’m a little bit ruled by my heart instead of my head. I know in every cell of my body that this is my path and it just felt wrong to do anything else. So I didn’t give up, even though so many times I felt like I needed to. I decided to interpret winning the money as the universe finally telling me that I’d done the right thing.
Where are you working now?
My main role is with Banksia Palliative Care, which is a charity in the northern suburbs of Melbourne. I’m part of a multidisciplinary team that provides community based palliative care. We offer nursing and psycho-social support, and we have an occupational therapist and music therapist as well.
I also work for Eastern Palliative Care and I do some private work with my own clients.
I’m sure your uncle would be proud.
He would be extremely proud. I think he would be quite chuffed to know that, because of him, I am now helping a lot of others. I know that my massages and my company meant a lot to him. He became a real advocate for me and for massage generally, so I think he would be over the moon.